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EVANSTON INSURANCE COMPANY CERTIFICATE NO.: 2011-28A CERTIFICATE OF INSURANCE COVERAGE EXCLUDED FOR NOMINEE EVENTS SEE SEPARATE APPLICATIONS FOR NOMINEE EVENTS. SPECIAL EVENT LIABILITY PROGRAM PRODUCER PUBLIC ENTITY (ADDITIONAL INSURED) Alliant Insurance Services, Inc. in conjunction with City of Santa Ana Apex Insurance 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: Braulio Mendez TYPE: Music c/o Dosis Music DATE(S): May 16, 2011 — December 31, 2011 809 E. Chestnut Street LOCATION: Senior Center Santa Ana, CA 92701 U O-7 _ 03 D _ 3 *Liquor Liability Yes EJ No **Liquor Liability after 12 am ends before 2 am This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy period indicated. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy listed and it does not constitute a contract between the insurance carrier, authorized representative, producer and certificate holder. The insurance described herein is subject to all the terms, exclusions and conditions of such policy(ies). INSURANCE CARRIER: Evanston Insurance Company MASTER POLiCV NUMHER: 11SPP100000I MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2011 EXPIRATION: JANUARY 1, 2012 COMMERCIAL OFNF.RA7_ LIA131L1TY OCCURRENCE. FORM DEDUCC'rISI.F.: NONF. General Aggregate Limit $ 2,000,000 Products & Completod Operations 1,000,000 P— al & Advertising Injury 1,0oo,000 Each Occurrence Limit 1.000,000 fire Damage (Any One [-ire) 50,000 medtcat Payments (Any Onc 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, the person or organi—tion shown in this schedule, but only with respect to liability arising out of the ownership, maintenance or use of the promises used by the named insured (event holder). This insurance does not apply to: Any "occu—ce" which takes place atter the event holder ceases to be a tenant in that premises. OTHER ADDITIONAL INSUREDS Fernando David Ballesteros Joel Hernandez CANCELLATIONShould the above described policy be cancelled before the expiration date thereof, notice will be del ivcrcd in accordance with the policy provisions. F.v.ry effort will be made to deliver 30 da s --nen notice to the certificate holder and AUTHORIZED REPRESENTATIVE: -'i 55 i5ta[1[ L_,;� DATE ISSUED: Revised certificate issued May 18 2011 by Briza Morales