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ARDENT ERGONOMICS (MELGOZA, JORGE)
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ARDENT ERGONOMICS (MELGOZA, JORGE)
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Last modified
10/23/2025 11:24:29 AM
Creation date
3/7/2025 10:01:50 AM
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Contracts
Company Name
ARDENT ERGONOMICS (MELGOZA, JORGE)
Contract #
N-2025-049
Agency
Human Resources
Expiration Date
2/18/2027
Insurance Exp Date
4/15/2026
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CM P-4787 <br /> Page 1 of 1 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESSOWNERS COVERAGE FORM <br /> SCHEDULE <br /> Policy Number:90-AP-K491-7 <br /> Named Insured: <br /> MELGOZA, JORGE B <br /> Name And Address Of Person Or Organization: <br /> City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers <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 CONDITIONS: <br /> We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we <br /> 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-completed operations <br /> hazard". <br /> This waiver applies only to the person or organization shown in the Schedule. <br /> All other policy provisions apply. <br /> CMP-4787 1008498 2001 151229 201 05-14-2019 <br /> ©, Copyright, State Farm Mutual Automobile Insurance Company,2008 <br /> Includes copyrighted material of Insurance Services Office, Inc.,with its permission. <br />
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