ACADEMY OF INTERNATIONAL DANCE (MUSKULIN, SONIA) 6 - 2010

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EVANSTON 1NSURANCE COMPANY CERTIFICATE NO.. 2010 -007 CERTIFICA'T'E OF INSURANCE F_XCLiIDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPLICATIONS b'OR NOMINEE EVENTS. SPECIAI. EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Instuance Services 20 Civic Center Plaza P. O. Box 6450 Santa Ana, CA 92701 Newport Beach, CA 92658 License No: OC 36861 NAMED INSURED (EVENT HOLDER): EVENT INFORMATION: Academy of International Dance TYPE: Ballet Attn: Sonia Mislculin DATE(S): 1/7/10 — 12 /l S/i O 220 E. 4`F' Street, Suite 202 LOCATION: Salgado Center Santa Ana, CA 92701 Liquor Liability Ycs � No * *Li uor Liabilit after 12 am ends before 2 am Q This is to certify that the policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. Limits shown may have been reduced by paid claims. INSURANCE CARRTER: Evanston Insurance Company MASTER POLICY NUMBER: lOSEP1000001 MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2010 EXPIRATION: JANUARY 1, 2011 C;OMMEKC'[AL GENERAL LIABILITY OCCURRENCE FORM DEDUCTIBLE: NONE General Aggregate Limit $ 2,000,000 Products Fi Completed Operations 1,000,000 Persona] ,� Advertising Injury 1,000,000 Each Occurrence i.imit 1,000,000 Fire Damage (Any One Fire) 50;000 Med lea! Payments (Any One Person) 5,000 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 insurance has been issued for that event "Who is insured" is amended to include, as an insured, [he person or organization shown in this schedule, but only with respect to IiabiliTy arising out of the ownership, maintenance or use of the premises used by [he named insured (oven[ holder). This insurance does not apply [o: Any "occurrence" which takes place after [he even[ holder ceases [o be a tenant in that premises. OTHER ADDITIONAL INSUREDS CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, the issuing company will mail 30 days written notice [o the cer[iFcate holder and additions] insureds listed. AUTHORILRD REPRESENTATIVE: �� DATE ISSUED: January 7 201 O b Briza Morales -�. P RO VEIJ AS TO FORM �� - -- � � ZYZ� o �]"- % a�.''iura Stl tl Sheedy, /�»IStan[ City Attorney