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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 2017-31 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />1PRODUCER <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction with <br />City of Santa Ana <br />Apex Insurance Services <br />20 Civic Center Plaza <br />R 0. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License No; OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Melina Herrera <br />TYPE: Presebool/Daveare <br />783 Olympic Avenue <br />DATE(S): 1/30/17 — 12/31/17 <br />Costa Mesa, CA 92626 ' <br />[C <br />LOCATION: Corbin Center <br />*Liquor Liability Yes F-1 No E <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(ics) unless <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SEP41023 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2017 EXPIRATION: JANUARY 1, 2018 <br />COMMERCIAL GENE'RAI. LIABILITY <br />OCCURRENCE FORM <br />DFDTXTIBLF: NONE, <br />General Aggregate Limit $2,000,000 <br />Products & Completed Operations 1,00(),000 <br />SPECIAL CONDITIONS: <br />Personal & Advertising Injijry 1,000,000 <br />The following endorsements attached to <br />Each Occurrence Limit 1,000,000 <br />the Master Policy do not apply to tHs <br />DarnageTo Premises Rented To You (Any One Premises) 100,000 <br />Cerifficate Of Insurance: <br />Medical Payments (Any One Person) 5,000 <br />Liquor Liability (if purchased) 1,000,000 <br />Optional Limits Purchased <br />$1,000,000/$3,000,000 <br />-1 <br />as <br />F $2,000,000/$2,000,000 <br />Damage'ro Property <br />a <br />o0. <br />(If purchased) <br />V <br />The limits of insurance apply separately to each event `insured by this policy as if a separate policy of insurance lias issued"{ <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />erovisions. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: January 30, 2017 By Stella Fajardo <br />