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Policy No. 92 :,BI426 CMP-4767 <br />Page 1 of 1 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br />CMP-4787 WAIVER OF TRANSFER OF RIGHTS OR RECOVERY AGAINST <br />OTHERS TO US <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE <br />Policy Number: 92 L31426 <br />Named Insured: <br />NANCY K BORL INC DBA THE CCUSS'ELING 'TEAM INTERSATICNAL AND DBA THE <br />O ISAKIZATIONAL _NETWORK <br />PO BOX 1C427 <br />SIN BERNRDNO CA 92423 0427 <br />Name And Address Of Person Or Organization <br />CITY OF SANTA AAA ITS OFFICERS SMPL•OY, ES AC3ZNT'S VOLU\TEERS a <br />REPRESE1N PATE `,?ES <br />20 CIVIC CENTER PLZ <br />SA_NTA AL:A CA 92701 105€9 <br />The following is added to Paragraph 10.b. of SECTION I AND SECTION 11 — COMMON POLICY <br />CONDITIONS: <br />We waive any right of recovery we may have against the person or organization shown in the Schedule <br />because of payments we make for injury or damage arising out of: <br />a. Your ongoing operations; or <br />b. "Your work" done under contract with that person or organization and included in the "products - <br />completed operations hazard". <br />This waiver applies only to the person or organization shown in the Schedule. <br />All other policy provisions apply. <br />CMP-4767 1006225 137715.1 11-19-2013 <br />CU, Copyright, State Farm Mutual Automobile Insurance Company, 2008 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />