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EVANSTONINSURANCE-"COMPANY <br />CERTIFICATE NO.: 635972.803573337829 <br />CEIt11FICATE OF INSURANCE <br />SPECIAL. EVENT LIABILFFY PROGRAM <br />PRODUCER <br />PUBLIC ENTH'Y (ADDITIONAL_ INSUIU-D) <br />Alliant Insurance services, Inc. in conjunction with <br />City of Santa Ana <br />Apex Instuance Services <br />Amended certificate replaces l.lie certificate issued to you on <br />P. 0. Box 6450 <br />April 26, 2016 <br />Newport Beach, CA 92653 <br />License No: OC 36861 <br />i <br />NAMED INSURED (EVENT HOLDER): <br />CVENT INFORMATION: <br />Valerie Valera <br />TYPE: Cooking <br />229 N Tustin Ave Apt C <br />DATE(s): 06/01/2016 to 09/30/2016 _ <br />Anaheim, CA 92807 <br />LOCATION: El Salvador Center <br />"'Liquor Liability Yes— No����� <br />"Li nor Liabilit nttei 1.2 am ends before 2 am ❑ <br />This is to certify That the insurance policy listed below has been issued to the above insures( named (event holder) loot 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 01, 2016 EXPIRATION: January 01, 2017 <br />('OkIMER(. IAI OENERALUABILd1) General <br />tit'CURRI'ME FORM <br />DIDUCHBLl. VANE <br />.Aggregale. Limit S 2,000,000 <br />Products & Completed [pmration6 1,000,000 <br />SPECIAL CONDITIONS; <br />Personal S: Adcenh ing Injw,, 1,000,000 <br />The followinitendorsemcn[s attached to <br />Each Oecon'ence Limit 1.000,000 <br />the Master Policy do not apply to this <br />Damage To Premises Rented To Yon (Ali) Ono Premises) 100,000 <br />Ceaiftcate 01' I nsorance: <br />Iriedicul Payments ( Any One Person) 5,000 <br />Liquor Liability (11purebased) 1,000,000 <br />Optional Limits Purchased <br />❑ $1,000,0001$3,000,000 <br />❑ s2,000,000/$2,000,000 <br />d,p� <br />Property Damage (If purchased) <br />��yiewe <br />No Property Damage Coverage <br />The limits of"our nce apply sepanaely to each avant in.urcd by this policy as ifillietEll ale policy or im, 1, <br />auet) fix Ihnt zve t <br />sk'a <br />on mo on <br />OTHER ADDITIT i AL INSUIW <br />l ANC 91Aj1,)vl Should Iha ahoyc dcwnbed policy be canvelled Mote the expiration date thereon, notice w-ill he delivered in acattdence wish the policv <br />xovisions. <br />AUTHORIZEDREPRESENIAFIVE: <br />DATE ISSU[D: 4/27/16 <br />