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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.. 2012 -29 <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 />Newport Beach, CA 92658 <br />Santa Ana, CA 92701 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Bea Tiritilli <br />TYPE: EcoloQV Camo <br />825 Clemensen Ave. <br />DATE(S): 06/18/2012 — 07/06/12 <br />Santa Ana, CA 92705 <br />* OCATION: SantiaQO Creek Nature Center <br />Liquor Liability Yes � No <br />* *Li uor Liabilit a$er 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 a matter 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 a contract between 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 policy(ies). <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: 12SEP1000001 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2012 EXPIRATION: JANUARY 1, 2013 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limrt $ 2,000,000 <br />Products 8c Completed Operations 1,000,000 <br />Personal � Advertising Injury L,OOQO00 <br />Each Occurrence Gmit 1,000,000 <br />h Baia �-� y� � .,� <br />L�1 � <br />�> 14 � � (;� : �, <br />Fire Damage (Any One Fire) 100,000 <br />Medical Payments (Any One Person) 5,000 <br />-. ,_ ; <br />Liquor Liability (If purchased) l,o00,000 <br />�.,i���� <br />- __..._.____. y,�__'_ - <br />_ ._ <br />ptional Limits Purchased <br />� -�� +�� �l.i <br />`:;lc�.civ <br />� $1,000,000/$3,000,000 <br />- `= �tstns�' z':ty <br />��t +ern," <br />� $2,000,000/$2,000,000 <br />The limits of insurance apply separately to each event insured by [his 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 even[ holder ceases to be a tenant in that premises. <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />rovisions. <br />�� � �l <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 06/14/12 by Briza Morales <br />