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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 635918285082375966 <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 />P. O, Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Josefina Lopez <br />TYPE: Speaking Engagements <br />2442 Folsom Street <br />DATE(S): 03/05/2016 <br />Los Angeles, CA 90033 <br />LOCATION: Santa Ana Public Library <br />*Liquor Liability YesC) No(D <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 such Ii unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41020 <br />MASTER POLICY DATES: EFFECTIVE: January01, 2016 EXPIRATION: January 01, 2017 <br />COMMERCIAL GENERAL LIABILITY General <br />OCCURRENCEFORM DEDUCTIBLE: NONE <br />Aggregate Limit $2,000,000 <br />Products & Completed Operations 1,000,000 <br />SPECIAL CONDITIONS: <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 tAny One Premises) I0(i <br />Medical Payments (Any One Person) 5.000 <br />Certificate Of I+uragce: <br />i.1,/, <br />vaewed <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />I <br />❑ $I,000,000/S3,000,000 <br />— <br />❑ 32,000,000/52,000,000 <br />Property Damage (If purchased) <br />Si via Cuevas <br />No Property Damage Coverage <br />P CSA/Admin, <br />The limits of insurance apply separately to each event fast -ad by this policy as if separate policy of insurance has been issued for drat event. <br />OTHER ADDITIONAL INSUREDS <br />CANCPL[.AT[0�: Should the above described policy be cancelled beimet the expiration date thereat, notice will be delivered in accordance with the policy <br />rovisiuns. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: <br />