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Declarations: <br /> Business LiabilityCoverage Part <br /> CONTINUED <br /> `"FTP.E9.RI fAII^3111 P.1111R ?Y r9+i? �n y4^.:I.n "r_r. . L <br /> Form Number Form Name Description Additional Details <br /> • City of Des Moines Attn: Location:400 Robert D Ray <br /> Procurement Drive Des Moines,IA 50309 <br /> Stanislaus County Location: 1010 10th Street <br /> Modesto,CA 95354 <br /> City of Hampton Location:22 Lincoln St., <br /> Hampton,VA 23669 <br /> ADDITIONAL INSUREDS SCHEDULES _410 <br /> Additional Insured Name <br /> Form Number Form Name Location <br /> and Address <br /> City of Santa Ana Risk Management N/A <br /> Division <br /> 20 Civic Center Plaza,SANTA ANA, <br /> CA 92702 <br /> The Anoka County Housing and N/A <br /> Redevelopment Authority Anoka <br /> County <br /> 2100 3RD AVE,ANOKA,MN 55303 <br /> City of Deltona N/A <br /> 2345 PROVIDENCE BLVD, <br /> DELTONA,FL 32725 <br /> City of Goldsboro"The City of N/A <br /> Goldsboro,its officers,employees <br /> and agents are additional insured <br /> under this insurance policy as <br /> required by written contract subject <br /> to policy terms,conditions or <br /> exclusions." i <br /> P.O.DRAWER A,GOLDSBORO, <br /> NC 27533 <br /> Town of Marana , N/A <br /> 11555 W CIVIC CENTER DR, <br /> MARANA,AZ 85653 <br /> • <br /> City of Stockton Its Officers,Officials, N/A <br /> Employees and Volunteers primary <br /> and non-contributory <br /> 400 E MAIN ST FL 3,STOCKTON, <br /> I CA 95202 <br /> City of San Bernardino N/A <br /> 290 N D ST,SAN BERNARDINO, <br /> CA 92401 <br /> City of Santa Barbara,CA P� <br /> Risk MsmagartentDivislon <br /> 630 Garden Street,SANTA r. REVIEWED&APPROVED BY: <br /> BARBARA,CA 93101 <br /> q.Iw '' Afrft Actimdo <br /> id, <br /> Form:SC 00 01 10 18 Risk Management Specialist pecialist <br />