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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2015-11 <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 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Geraldine Valencia <br />TYPE: Gymnastics <br />940 W. Chapman, Suite 100 <br />DATE(S): 1/16/15— 12/31/15 <br />Orange, CA 92868 <br />LOCATION: Garfield Center <br />*Liquor Liability Yes ❑ No <br />**Liquor Liability 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. The husurance described herein is subject to all the terms, exclusions and conditions of such policy(ies) unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41017 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2015 EXPIRATION: JANUARY 1, 2016 <br />COMMERCIAL GF,NERAI, LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE: NONE <br />General Aggregate Limit $ 2,000,000 <br />Products & Completed Operations 1,000,000 <br />SPECIAL CONDITIONS: <br />Personal & Advertising Injury 1000,000 <br />'fhe following endorsements attached n <br />Each Occurrence Lindl L000,000 <br />the Master Policy do not apply to this <br />Damage To Promises Ranted To You (Any One Premises) 100,000 <br />Cenificute Of Insurance: <br />Medical Payments (Any One Person) 5.000 <br />by <br />Liquor Liability (If purchased) 1.000,000 <br />ReVlew ed <br />Optional Limits Purchased <br />17 $1,000,000/$3,000,000 <br />❑ S2,000,000/$2,000,000 <br />GUeVa <br />Damage To Property (if purchased) <br />SIjVIe <br />PRCSAIAdmi <br />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. <br />OTHER ADDITIONAL INSUREDS <br />Flor Hernandez <br />Michael Zapata <br />CANCELLATION: Should the above described pokey be cancelled before the expiration date thereof. notice will be delivered in accordance with the policy <br />provisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: January 16, 2015 by Briza Morales <br />