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<br />EVANSTON INSURANCE COMPANY <br />CERTIF1CATE NO.: <br /> <br />CERTIF1CATE OF INSURANCE <br />EXCLUDES COVERAGE FOR NOMINEE EVENTS. SEE SEPARATE APPUCATIONS FOR NOMINEE EVENTS. <br />SPECIAL EVENT UABIUTY PROGRAM <br /> <br />PRODUCER: <br /> <br />PUBUC ENTITY (ADDITIONAL INSURED) <br /> <br />Driver Alliant IDsurance Services <br />P.O.Box28323 <br />Santa Ana, CA 92799-8323 <br />(949) 660-8163 <br />License No: OC 36861 <br />NAMED .IN~ (~VENT HOLDER): N ~,;?{)O3 - tJ9'1 <br />SOI'UA. M-Uc.u.Un <br />220 E. Fouldh S-tlLee-t, Su..Ue 202 <br />Sa.nto. Ana., CA 92102 <br /> <br />City of Santa Ana <br />20 Civic Center Plaza, 11-28 <br />P.O. lIox 1988 <br />Santa Ana, CA 92'702 <br /> <br />TYPE: <br />DATE(S): <br />LOCATION: <br /> <br />This is to certifY that the policies of insurance listed below have been issued 10 the Insured ru!xm:d above for !he policy period <br />indicated. NotWithstan<Üng any requirements, tenns or cOnditiODS of any contracl or other documenl witb respect to wluch Ihi. <br />certificate may be issued or may pertain, the insurance afforded by !be polici.. descrifred herein is subjecl to all the term.'>. <br />exclusions and conditions of such policies. Limits shown may have been redlJ£ed by paid claims. <br />INSURANCE CARRIER: Evanston InsUI1lIlCe Company <br /> <br />MASTER POUCY NUMBER: 04SEPIOOOOOI <br /> <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2004 EXPIRATION: JANUARY 1,2005 <br /> <br />COMMERCIAL GENERAL LIABILITY <br />General A¡gn:gate Umi' <br />Products &. Cumploted Oper2Þons <br />Pmunal&AdvertisingInjUJ)' <br />Eoch OccUIT"":O Urnil <br />Fm: Damage (Any One Fire) <br />Medioal Payments (Any One Penon) <br /> <br />OCCURRENCE FORM <br /> <br />I) ¡DUCTIBLE; NONE <br /> <br /> <br />The limits of ;,uunuu:o apply acpa....ly 10 each even, in...... by lI1ia policy aa if. -"' ...IÍ\:Y of """'Iõm<:< ¡,.,....n ¡"oed tor 11m.."'" <br />"WIIo is insu..... i,amended to include, aa... inau"", 1110 penon 0< organization shown in thia _Ie. bu,only wi," -,It> lí#bility msing<N,nt.", <br />OWIICBhip. maintenance 0< use of the premises used by the named in""" (even' holder~ lbia insu.."", ""'" nol apply In: Any"""""""".." wh,'" "",,-. pI... <br />after the evenl holder ......10 be. 1""'1 on mat ¡m:rn"" <br />--- OTHER ADDITIONAL INSUREDS ..-. <br /> <br />CANCElLATION' Should the...... described policy 10 cane.net! hef"",I'" cxpinotion date """f, the i..uins company will mait30 days wri.ten noticoto tile <br />cortificate bolda- and addi!;....1 in.....u liated. <br /> <br />~ <br />,~ <br />AUTHORIZED REPRESENTATIVE: i5M>titYj ~ <br />(j <br />DATE ISSUED: 1/5/04 <br /> <br /> <br />ç., .. <br />