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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.. 6358-95902164758672 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITYPROGRANI <br />PUBI.AC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction with <br />Apex Insurance Services <br />City of Santa Ana <br />P. O. Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED I-NSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Karina Morales <br />9772 Santiago Blvd i\)" <br />TYPE: Ballet <br />DATE(S): 02/04/2016 - 12/31/2016 <br />Villa Park, CA 92867 <br />LOCATION: Santanita Park <br />*Liquorl.Jability Yes o 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 insurance described herein is subject to all the terms, exclusions and conditions Of SLICh policy(ies) unless <br />amended as described in Special Conditions, <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41020 <br />MASTER POLICY DATES: EFFECTIVE: January 01, 2016 EXPIRATION: January 01, 2017 <br />COMMERCIAL GENERAL LIABILITY General <br />OCCURUNCE FORM <br />DEDUCTIBLE NONE <br />Aggregate Limit S2,000.000 <br />Products & Cumpleted Operations 1,000,000 <br />personal & Advertising Injury 1,000,000 <br />Fach OCCUrrence Limit 1,000.000 <br />Dama-cTo Premises Rented] o You (Any One Premises) l 00,000 <br />Medical Payments (Any One Person) 5,000 <br />SPECIAL CO N 1) 111 ON S: <br />fhe following endorsements attached to <br />the Maoer Policy (k) not apply to this <br />Certificate Of Insuranre; <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />El $1,o00,00053,000,000 <br />❑ $2,000,00062,000,000 <br />Property Damage (if purchased) <br />No Property Damage Coverage <br />. \e.NNe <br />A <br />The limits of insurance apply separately to each event insured by this policy as if a separate 170 �111 of incur Ne issued For that event. <br />Y\-- <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above described policy be cancelled before the expiration date tlrcreof, notice will be delivered in accordance with the policy <br />provisions, <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 01/28/2016 <br />