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NSURANCE COMPANY <br />NO.: 2008-06 <br />CERTIFICATE OF INSURANCE <br />~a~r,vur.a COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR <br />SPECIAL EVENT LIABILITY PROGRAM <br />NOMINEE EVENTS. <br />PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED) <br /> City of Santa Ana <br />Alliant Lssluance Services, Inc. in conjmction with 20 Civic Center Plaza, M-28 <br />Apex h>atuance Services Santa Ana, CA 92701 <br />P. O. Box 6450 <br />Newport Beach, CA 9265 S <br />(949)660-8135 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />Virelnia Mayne TYPE: Resume Wdtlne <br />1601 E. Avalon Ave. DATE(S): January 2008 -December 2008 <br />Santa Ana, CA 92705 LOCATION: Saata Ana WORK Center <br /> "Liquor Liability Yes ^ No <br /> "•Li uor Liabili after I2 amends before 2 am <br />This is to certify that the policies of instaanct listed below have been issued to the insured Warned above for the policy period <br />indicated. Notwithstanding any requittments, terms or conditions of any contraM or other doclunent wide respect to which this <br />certificate may be issued or may pertain, the inenn~w afforded by the policies descnbed herein is subjat to alt the tetras, <br />exclusions and conditions of such policies. Limits shows may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 04SEP1000001-0 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2008 EXPIRATION: JANUARY 1, 2009 <br />COMMERCIAL GENERAL LIABILR'Y OCCURRENCE FORM DEDUCIBLE: NONE <br />General Aggregate Limit S 2,000,000 <br />Producn & Completed Opttations 1,000,000 <br />Personal & Advertising ]njury 1,000A00 <br />Each Occurrcnx Limit 1,000,000 <br />Fire Damage (My One Fire) 50,000 <br />Medical Payments (Myyne Person) 5,000 <br />Liquor Liability (If purchased) i•~~ <br />The limits or insurmce ly separately to each event insured by [leis policy u ifs operate policy of imurmce has been jawed for that event <br />"Who is insured" is amended to include, as an inwred, the person or organvation shown in this schedule, but only with respect W liability arising out of the <br />ownership, maintenance or use of the premises uud by tM named insured (event holder). Thu inwnntt does not apply to: My "occurrence' which takes place <br />alkr the event holder ceases to be a tenant in that premises. ' <br />OTHER ADDTTIONAL INSUREDS <br /> <br />CANCELLATIOM Should the above described policy to cancelled before the ezpinfion date thereof, the iswing company will mai130 days written nobtt W the <br />certificnc holder and additional inwreds listed. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />,(~uo~~, <br />