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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2.016-15 <br />CERTIFICATE OF INSURANCE. <br />SPECIAL EVENTLIABILITY PROGRAM <br />PRODUCER <br />PUBLIC. ENTITY (ADDITK)NAL 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. CO. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach„ CA 92658 <br />License No: tOC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION:. <br />Yessica Campos <br />TYPE: Glance <br />7082 Senrvay Drive, Apt. 5,�d °. t' 1� ��. <br />DA"I'E(S): 01107d16— 12I31116 <br />Westminster, CA 92683 <br />LOCATION: Memorial Center and Santa Anita Center <br />*Liquor Liability YesEl No V <br />**Liquor Liability after 12 anti ends before 2 am <br />This is to certify that the insurance policy listed below has been issued to the above insured naned (event holder) for the policy <br />period indicated. The insurance described herein is subject to all the terns, exclusions and conditions of such policy(ies) unless <br />atnended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41.020 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2016 EXPIRATION: JANUARY 1, 2017 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUC;fIBI-L NONE <br />General. Aggregate Lira t $ 2,O00,000 <br />Products its Completed Operations I,000„,000 <br />SPECIAL CONDITIO'NS, <br />Personal & Advertising Injury 1,000,000 <br />The following endorsements attached to <br />Each Occurrence Limit 1,000,000 <br />the Master Policy do not apply to this <br />Damage To Premises Rented To You (Any One Preimses) 100,000 <br />Certificate Of Insurance: <br />ivleddcal Payments (Any One Person) 5,000 <br />LiquorLiabil'ity (if purchased) I,000,000 <br />, <br />(Optional Limits Purchased <br />���`► " <br />El $ 1,000,000153,000,000 <br />FI $2,000,00052,000,000 <br />n, " <br />[Damage To Property (If purchased) <br />The hmits of insurance apply separately to each event insured by this policy as ifa sepa� po;lrcy "' r has been issued for that event. <br />OTHER ADDITIO ',AL INS S <br />Laura Campos <br />CANCELLATION- Should the above described policy be cancelled before the expiration date thereof; notice will be delivered in accordance with the policy <br />Provisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: Januar 7 2016 by Briza Morales <br />