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EVANs'rON INSURANCE COMPANY <br />CERTIFICATE NO.: 2016-06 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT` LIABILITY PROGRAM <br />PRODUCER <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 />P. O. Box 6450 <br />Santa Ana, CA 92701 <br />Newport Beach, CA 92658 <br />License No: OC 368611 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT" INFORMATION: <br />Pat Hurley c <br />TYPE: Music <br />14920 Minneola Court <br />DATE(S): 01/01/16 —12/31/16 <br />Tustin, CA 92780 <br />LOCATION: El Salvador Center <br />*Liquor Liability Yes [:1 No E <br />"Liquor Liability after 12 am ends before 2 am Ej <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) UnIeSS <br />amended as described in Special Conditions. <br />INSURANCE CARRIER: Evanston Insurance Company <br />MASTER POLICY NUMBER: SE11141020 <br />MASTER POLICY DATES: EFFECTIVE: JANUARY 1, 2016 EXPIRATION: JANUARY 1, 2017 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />DEDUCTIBLE- NONE <br />General Aggregate Limit S2,000,000 <br />Products & Completed Operations 1,000,000 <br />SPECIAL CONDITIONS; <br />Personal & Advenising lfliUry I'(104),wo <br />the following endorsements attached to <br />Each OCCUrrence Limit 1,000,000 <br />the Muster Policy do not apply to this <br />Damage To Premises Rented To You (Any One Premises) I oo'00() <br />Certificate Of lnsurancc: <br />Medical payments (Any One Person) 5,000 <br />Liquor Liability (if purchased) 1,000,000 <br />Optional Limits Purchased <br />6 ' Jl <br />El $1,000,0001$3,000,000 <br />F❑1 $2,000,00052,000,000 <br />Damage To Property (if purchased) <br />WA <br />Ar6\\ <br />The limits orinsurance apply separately to each event insured by this policy as if a separate policy qJ;me<.nce ]%?"' i4z is P,']'.tevent <br />OTHER ADDITIONAL INSUREDS V <br />CANCELL,AT9ON: Should the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance kvith the policy <br />Provisions. <br />AUTI IORIZED REPRESENTATIVE: <br />DATE ISSUED: December 16,2015 by Briza Morales <br />