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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2015-11 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER <br />ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction with <br />f Santa Ana <br />Apex Insurance Services <br />ic Center Plaza <br />P. O. Box 6450 <br />rIPUBLIC <br />Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT I ]OLDER): <br />T' INFORMATION: <br />Geraldine Valencia <br />TYPE: Gymnastics <br />940 W. Chapman, Suite 100 <br />DATE(S): 1/16/15 --12/31/15 <br />Orange, CA 92868 <br />LOCATION: Garfield Center <br />*Liquor Liability Yes ❑ No El <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 policy(ies) unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41017 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2015 EXPIRATION: JANUARY 1, 2016 <br />COMMERCIAL GENERAL LIAnII I'Y <br />OCCURRENCE FORM <br />DHA UC1111If' : NON[ <br />General Aggregate Limit $2,000,000 <br />Products & Completed Operations 7,000,000 <br />SPECIAL CONDI TIONS: <br />Personal & Advertising Injury 1,000,000 <br />'the following endorsements attached to <br />Each Occurrence Limit I M)0,000 <br />the Master Policy do not apply to this <br />Dantage'to premises Rented To You (An), One Premises) 100,000 <br />Certificate Of Insurance: <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) Ifab)'000 <br />Optional Limits Purchased <br />❑ $1,000,000/$3,000,000 <br />❑ $2,000,00052,000,000 <br />Damage To Property (If purchased) <br />"Ihe limits of insurance apply separately to each event insured by this policy as if a separate policy of insurance has been issued for that event. <br />OTHER ADDITIONAL INSUREDS <br />Flo• Hernandez <br />Michael Zapata <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: January 16, 2015 by Briza Morales <br />