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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 636029001373122651 <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 Set -vices <br />P. 0. Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENTINFORMAT[W <br />Angelical Ramirez U71 "�4 <br />TYPE: Painting <br />3006 S Deegan Dr. t <br />DATE(S): 07/01/16 - 12/31/16 <br />Santa Ana, CA 92704 <br />LOCATION: El Salvador & Jerome Center <br />*Liquor Liability Yes C) Noe <br />I **Liquor Liability after 12 am ends before 2 arn El <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 pohey(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 />1 <br />COMMERCIAL GENERAL LIABILITY General OCCURRENCE FORM DEDUCTIBLE: NONE <br />Aggregate Limit $2,000,000 <br />Products & Completed Operations 1,000,000 SPECIAL CONDI 11ONS: <br />Personal & Advertising Injury 1,000,000 The following endorsements attached to <br />Each Occurrence Limit 1,000,000 the Master Policy do not apply to this <br />Damage To premises Rented To YOU (Any One Premises) 100,000 Certificate OfInSUrance: <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />El $1,000,00053,000,000 , k, <br />$2,000,00052,000,000 <br />Properly Damage (if putt -ch. qsed) Owl' <br />No Property Damage Coverage 6 <br />The HrnitS Ot'111SUrance apply separately to each event insured by this policy as ifa separate policy of insurance has Wffi'�sied ror that event. <br />OTHER ADDITIONAL INSUREDS <br />CANCE1A,AT1 N Should the above described policy be cancelled before tile expiration date thereof, notice will be dchvered in accordance with the policy <br />provisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 06/30/2016 Revised on 716116 by 13. M. <br />