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EVANSTON INSURANCE COMPANY <br />CERTIFICATE NO.: 635975204871568375 <br />CERTIFICATE OF INSURANCE <br />SPECIAL EVENT LIABILITY PROGRAM <br />PUBLIC ENTITY (ADDITIONAL INSURED) <br />Alliant Insurance Services, Inc. in conjunction with <br />City of Santa Ana <br />Apex Insurance Services <br />P. O. Box 6450 <br />Newport Beach, CA 92658 <br />License No: OC 36861 <br />NAMED INSURED (EVENT HOLDER): <br />EVENT INFORMATION: <br />Valerie Valera XA <br />TYPE: Cooking <br />229 N Tustin Ave., Apt C <br />DATE(S,): 06/03/2016 - 12130/2016 <br />Anaheim, CA 92807 <br />LOCATION: El Salvador Center <br />*Liquor Liability Yes o No <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: SEP41020 <br />MASTER POLICY DATES: EFFECTIVE: January 01, 2016 EXPIRATION: January 01, 2017 <br />COMMERCIAL GENERAL LIABILITY General <br />OCCURRENCE FORM <br />DEDUCTIBLE NONE <br />Aggregate Limit $2,000,000 <br />products & Completed Operations 1,000,000 <br />SPECIAL CONDITION&: <br />Personal & Advertising Injury 1,000,000 <br />The following endorsements atladied to <br />Each Occurrence Limit 1,000,0001 <br />theNlaster Policy do not apply to, this <br />Damage To Prernases Rented To YOU (Any One Premises) 100,000 <br />Certificate Of Insurance: <br />Me&cal payments (Any One Person) 5,000 <br />Liquor Liability (if purchased) 1,000,000 <br />Optional Limits Purchased <br />$1,000,0001$3,000,000 <br />El $2,000,00052,000,000 <br />Property Damage (If purchased) <br />No Property Damage Coverage <br />I kn. <br />P"JPOM <br />The limits of insurance apply separately to each event insured by this policy as ifa separate policy Of insurance has been —issued for that event, <br />OTHER ADDITIONAL INSUREDS <br />CANCELLATION: S1101.11d the above described policy be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy <br />provision-,. <br />AUTHORIZED REPRESENTATIVE: <br />DATE ISSUED: 04/29/2016 <br />