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EVANSTON MURANCE COMPANY CERTIFICATE NO.: 2008-39 CERTIFICATE OF INSURANCE EXCLUDES COVERAGE FOR NOMINEEDE I AI EVENT EF SEPARATE APP 1CATIONS FOR NOMINEE EVENTS• PUBLIC ENTITY (ADDITIONAL INSURED) PRODUCER: City of Santa Ana Alliant Insurance Services, Inc. in conjunction with 20 is CenterPlaza M-28 Apex Insurance Services Santa CA 92701 P. O. Box 6450 Newport Beach, CA 92658 (949)660-8135 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Flor Hernandez TYPE: Aerobics DATE(S): November 1— December 31 2008 1621 N. Linwood Ave. LOCATION: Senior Center — 3 Street Santa Ana, CA 92701 *Liquor Liability Yes ❑ No N **Liquor Liabiii after 12 am ends before 2 am This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period or other document with respect to which this indicated. Notwithstanding any requirements, terms or conditions of any contract be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, certificate may exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRIER: Evanston Insurance Company MASTER POLICY NUMBER: 04SEP10000014 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2009 EXPIRATION: JANUARY 1, 2009 COMMERCIAL GENERAL LIABILITY OCCURRENCEFORM DEDUCTIBLE: NONE General Aggegete Limit S 2,1100,000 1.000,000 Products & Completed Operations 1,000.000 Personal & Advertising Injury Each Occurrence Limit 11000,000 Fire Damage (Any One Fire) 50,000 5,000 Medical Payments (Any one Person) Liquor Liability (If purchased) 1,000,000 The limits of insurance apply separately to each event insured by this policy as if a separate policy of miturmsec has been issued for that event "Who is insured" is amended to include, es an insured, the person a organization shown in this schedule, but only with respect to liability arising out of the ownership, maintenance or use ofthe premises used by the named insured (event bolder). This insurance does not apply to: Any "cecurrence" which takes place after the event holder ceases to be a tenant in thstpromises. OTHER ADDITIONAL INSUREDS Michael Saucedo Nutritional Supplement Juan Sanchez Inner City Child Development Youth Foundation dames S. Stapleton CANCELLATION: Should the above described policy to cancelled before the expiration date thereof, the issuing company will mail 30 days written notice to the certillcate holder and additional insureds listed. /,v �Z, A , Vn VORM AT ITI-IORLZED REPRESENTATIVE: DATE ISSUED: