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<br />EY ANSTON INSURANCE COMPANY
<br />CERTIFICATE NO.:
<br />
<br />CERTIFICATE OF INSURANCE
<br />EXCLUDES COVERAGE FOR NOMINEE EVENTs. SEE SEPARATE APPUCATIONS FOR NOMINEE EVENTs.
<br />SPECIAL EVENT UABIUTY PROGRAM
<br />
<br />PRODUCER: PUBUC ENTITY (ADDmONAL INSURED)
<br />Driver Alliant lDsuraDce Services City of Santa Ana
<br />1'0 Box 28323 20 Civic Center Plaza. M-28
<br />Sanre Ana. CA 927')9.8323 P.O. 1'10" 1988
<br />., ". Santa Ana, CA 92702
<br />OC 36861
<br />NAMED INSURED (EVEJ'ff HOLDER): ~ INrO~}lf~inp!tovement - I t\I, tlUu:t~mUl
<br />Sdìm,¿dt
<br /> N. MíLLI: S:tlteeA: !I~ ~CD¿'- wl ÐATF.(S): ..1l1/V" - 12/51/04
<br /> An't, CA LOCATION: S.A, J<Ut
<br />
<br />litis IS to cemty tbat the poJíelCli of ÍDB"""""e listed below bave been issued to the insured I1IIIIII>d above for the policy period
<br />indicated. Notwithstanding any requirements, temJS or conditions of any contract or other docwœnt with respect to which tbis
<br />certificate may be issued or may pertain, the insnrance afforded by the policies described herein is subject to all the terms,
<br />exclnsions and conditions of sw:h policies. LimiIl shown may bave been reduced by paid claims.
<br />INSURANCE CARRŒR: Evanston Insurance Company
<br />MASTER POLICY NUMBER: 04SEP1000001
<br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1,2004 EXPIRATION: JANUARY 1, 2OOS
<br />COMMERCIAL GENERAL LlABIUTY OCCURRENCE FORM DEDUCTIBLE: NONE
<br />Genm.\ Aasn:ple Limit $ 2,000,000
<br />Products &0 COIT >1e1ed Openti... 1.000.00o
<br />PcnonaI &0 Adv....i., "'iu')' 1,000.000
<br />FA'" 'k.""'tlu~C U",u i .000,000
<br /> 50,000
<br /> S.OOO
<br />n" Hmi" ði '^"'-"f'I"Y "'P'...tcly ," """ """'" "',..",¡ by lIIi. policy.. ifa -- policy of i----'" -. issued for - ovent
<br />"WiK> " on""""",, .,,_.. In ",d_.... -.11><- ororpn;..,;.. shown ;nlhil_ule, bulonlywilb.apo....liobility.,;,;naOUloflbo
<br />""v'.<h,p. m""""""" w """ of "'" P""m- """" by'", ..- ino- (.....t holder), _......... dooo 1101 opply.., Any""""""'" wbich taka place
<br />.~è~ ,"""',mhoJ<k,cc_lobt....,.,u¡uu......"",,,
<br /> OTHER ADDITIONAL INStJREDS
<br />
<br />C6!'CEJJ ^TION' Sbooklfuc """"l!oscrilledpolitylo<:a1l<OlIedbeforotbc:oxpi..1ionda1o Ihaoof. tbc: iauinB ""'1""Y will mail30doys wriuen notice.. Ihc
<br />""¡iiça.................._I_I......
<br />
<br />,,-;) /ZJ
<br />AUIHORIZED REPRESENTATIVE: ~4~ ~
<br />
<br />DATE ISSUED: 4/01/04
<br />
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