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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2013-11 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction With <br />City of Santa Ana <br />Apex Insurance Services <br />20 Civic Center Plaza <br />P. O. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 42658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Patrick Hurley <br />'TYPE: Music <br />14920 Miumbila Court <br />DATES) 91/07/13 -12131/13 <br />Tustin, CA 92750LOCATION: <br />El Saly doh enter <br />�-1-0Lk'-0{�'b <br />*LiquorIiability Yes . Nod <br />**Lt nor Liabilit after 12 am ends before 2 am. ❑ <br />This is to certify that the insurance policy listed below has been issued to the above insured named (event holder) for the policy <br />period indicated. This certificate is issued as amatter of information only and confers no rights upon the certificate holder. This <br />certificate does not affirmatively or negatively amend, extend or alter the coverage afforded by the policy listed and it does not <br />constitute contractbetween the insurance carrier, authorized representative,. producer and certificate holder. The insurance. <br />described herein is Subject to all the terms, exclusions and conditions of such pellicy(les). <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER, POLICY NUMBER: SEP41011 <br />MASTER POLICY BATES: EFFECTIVE: JANUARY 1, 2013 EXPIRATION: JANUARY,L 2014 <br />COMMERCIAL OENER,&I. LIABILITY <br />OCCURRFNCB FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit $2,000,000 <br />Products & Completed Operations 1,000,000 <br />Personal & Advertising injury 1,000,000 <br />Each Occurrence Limit 1,009,000 <br />Fire Damage.(Any One Eire) 100,000 <br />Medical Payments (Any One. Person) 5,000 <br />Liquor Liability (if purchased) l,00gapa <br />Optional Linens Purchased <br />❑ $1,000;0001$3,000,000 <br />0 $2,000,000152,900,000 <br />The limits of insurance apply separately to each event insured bythis policy as if a svTiarate policyyof insurance has been issued for that event. <br />"Who's insured" is amended to include, as an insured, the person or orgammition shown in this schedule, but only with respect to liability arising out of the <br />ownership, maintenance at use of the premises mod 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 tenam in that prem ses __ <br />OTHER ADDITIONAL INSUREDS <br />C1jECELLATION Should the above described policy be cancelled bePnra the expiration One, thereof, nmice will be delivered in accordance with the policy <br />provisions, <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: January 7.2013 be Briza Morales <br />