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TF Policy No. 92 CRP647 1 75-1404 CMP-4787 <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 CRP647 1 <br />Named Insured: <br />JOHNSTON, SARAH <br />DBA SHOWTIME DANCE COMPANY <br />410 W 4TH ST STE A <br />SANTA ANA CA 92701-4567 <br />Name And Address Of Person Or Organization: <br />THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AND VOLUNTEERS ARE TO <br />BE COVERED AS ADDITIONAL INSURED WITH RESPECT TO LIABILITY ARISING OUT <br />OF WORK OR OPERATIONS PERFORMED BY OR ON BEHALF OF INSURED INCLUDING <br />MATERIALS, PARTS OR EQUIPMENT FURNISHED IN CONNECTION WITH SUCH WORK <br />20 CIVIC CENTER PLZ <br />SANTA ANA CA 92701-4058 <br />The following is added to Paragraph 10.b. of SECTION I AND SECTION II — 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-4787 1006225 137715.1 11-19-2013 <br />©, Copyright, State Farm Mutual Automobile Insurance Company, 2008 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />J''" � <br />,0:'--'.- g <br />R7akMwgemmtDlvieirnt <br />RwEwED&APPRo mBr. <br />® <br />Risk Management Spedalist <br />