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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2009-19 <br />CERTIFICATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER: PUBLIC ENTITY (ADDITIONAL INSURED} <br /> City of Santa Ana <br />Alliant Insurance Services, Inc. in conjunction with 20 Civic Center PIaza <br />Apex Insurance Services Santa Ana, CA 92701 <br />P. O. Box 6450 <br />Newport Beach, CA 92658 <br />(949) 660-8135 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: <br />Sue Montelone TYPE: Instructional Course (Resume Writing) <br />19918 Pasea Lorenzo DATE(S): June 8.2009 -December 31, 2009 <br />Yorba Linda, CA 92886 LOCATION: Santa Ana WORK Center <br /> *Liquor Liability Yes ^ No <br /> **Li uor Liabili after 12 am ends before 2 am ^ <br />This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period <br />indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this <br />certificate maybe issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, <br />exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 04SEP 1000001-5 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2009 EXPIRATION: JANUARY 1, 2010 <br />COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE <br />General Aggregate Limit $ 2,000,000 <br />Products & Completed Operations 1,000,000 <br />Persona] & Advertising Injury 1,000,000 <br />Each Occurrence Limit 1,000,000 <br />Fire Damage (Any One Fire) 50,000 <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased} t,ooo,ooo <br />The limits of insurance apply separate]y to each event insured by this policy as if a separate policy of insurance has been issued for that event. <br />"Who is insured" is amended to include, as an insured, the person or organization shown in this schedule, but only with respect to liability arising out of the <br />ownership, maintenance or use of the premises used by the named insured (event holder). This insurance does not apply to: Any "occurrence" which takes place <br />after the event holder ceases to be a tenant in that premises. <br />OTHER ADDITIONAL INSUREDS <br /> <br />CANCELLATION: Should the above described policy to cancelled before the expiration date thereof, the issuing company will mai130 days written notice to the <br />certificate holder and additional insureds listed. <br />~~t!' <br />~~~~~ <br />AUTHORIZED REPRESENTATNE: <br />DATE ISSUED: June 8. 2009 /~`y~-~~f__~!~~~,r„~ <br />