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POLI~Y NUMBJi~: POLIC~ TYPE: <br />2~Q2-03[126 LIABILITY <br /> <br />ADDITIONAL tNSURED,--DF~IQNATED PERSON OR ORGANIZATION: <br />CITY OF ~I~ITA ANA <br /> <br />THI~I ENDORSEMENT MODIFIES INSURANO~ pROVIDED UNDER THE FOLLOWING: <br /> <br />PQLACT TYPE: <br />LIABILITY <br /> <br />'::CHI;:DULE: <br />1.tJl~':~OO~ - 12J'16/20~ <br />NAME OF PERSON OR ORGAH]Z.,ATIC)N: <br />CITY OF SANTA ANA <br /> <br />THIS INSU~.N~ SHALL BE PRIMARY <br /> <br />Of ne ent~ appears above, Information reclUlred to complete this endorsement <br />will be shown in the Declarations as applicable to this endorecmont.) <br /> <br />WHO I$ AN INSURED (section il) is amended to Jnctudu as Insured the person or <br /> <br />organization shown in the Schedule as an fnsu.red bUt only with respect to <br />liability arbin~ out oi your operatJon~ o~ ptemLso~ owned by or rentt~d to <br /> <br />~opyrlght, I~surallc~ services Office. Inc. 19~4 <br /> <br />APPROVED AS TO FORN.~ <br />Deputy City Atto/ney <br /> <br />711 479 0153 MAR.31'2003 12:55 RECEIVED RROM: 9164411732 #2781-003 <br /> <br /> <br />