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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2016-02 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PRODUCER <br />PRODUCER <br />0 UCL <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />li t Insurance <br />Alliant Insurance Services, Inc. in conjunction with <br />City of Santa Ana <br />Apex.x Insurance <br />pex Insurance Set -vices <br />I "' 11c <br />20 Civic Center Plaza <br />P P 0 . Box <br />. O. Box 6450 <br />Santa Ana, CA 92701 <br />Newport e c <br />Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Bertha Jauregui ('111? , (" , (-, <br />; TYPE: Preschoo]JDayeare <br />2422 S. Shelton Street <br />DATE(S): 01/01/16 — 12/31/16 <br />Santa Ana, CA 92707 <br />LOCATION: Memorial Center <br />*Liquor Liability Yes 0 No M <br />"LiqUor Liability after 12 am ends before 2 am 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 policy(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 1, 2016 EXPIRATION: JANUARY 1, 2017 <br />COMMERCIAL. GENERAL I.1A13If,ITY <br />OCCURRENCE FORM <br />DEDUCTIBI-I': NONE <br />General Aggregate Limit $2,000,000 <br />Products & Cornpleted Operations 1,000,000 <br />SPFCIAI, CONDITIONS. <br />personal & Advertising IIIJUIFY 1,00(),000 <br />The following endorsements attached to <br />F.'ach Occurrenc,e I-irnit 1,000,000 <br />the Master Policy do not apply to this <br />Damage To Premises Rented,ro YOU (Any One Premises) 100,000 <br />Certificate ONTISUranm <br />Medical payments (Any One Person) 5,000 <br />Liquor Liability (If purchased) 1,000,000 <br />Optional Limits Purchased <br />[:1 $1,000,00053,000,000 <br />F❑1 $2,000,000/$2,000,000 <br />DarnageTo Property <br />(if purchased) <br />t <br />The IllnitS Of insurance apply separately to each event insured by this pohey as if a <br />separate policy o' all <br />OTHER ADDITIONAL INS REDS <br />CANCI',IJWI]W Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />provisiolls. I <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: December 15, 2015 by Briza Morales <br />