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BAUTISTA, SANTIAGO
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BAUTISTA, SANTIAGO
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Last modified
8/24/2022 10:55:40 AM
Creation date
5/14/2019 3:23:23 PM
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Contracts
Company Name
BAUTISTA, SANTIAGO
Contract #
N-2019-081
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
6/30/2020
Destruction Year
2025
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POLICY NUMBER: 68RPG0000007213900 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />PRIMARY INSURANCE — ADDITIONAL INSURED <br />This endorsement modifies insurance under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE FORM <br />SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance, a. the following is added: <br />Coverage afforded under this Policy is primary insurance and OTHER INSURANCE shall not apply as respects to the <br />additional insured named below, however this insurance does not apply to the sole negligence of such additional insured. <br />Further, we will have no duty to defend such additional insured against any suit to which this insurance does not apply. <br />Additional Insured: City of Santa Ana Risk Management Division <br />20 Civic Center <br />Santa Ana, CA, 92701 <br />Named Insured: Santiago Bautista <br />DBA: Te-Kenjutsu-Kan Karate -Do <br />C P# 3 <br />Effective Date: 01/01/2020 - 01/01/2021 <br />REVIEWED & APPROVED <br />By Risk NAGEMENT DIVISION <br />302020 <br />M. LAMBERT <br />SRPG8018 09/08 <br />
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