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<br />.. 1i.,..II-I' "ilho h...-III l"mNATIIIIlA~ 410Z21OQII <br />~. oa/lT/04 Ot:11 FAl 1 .~. III 0144 NAKOIA WMUU~ <br />_-lD-'~ 104 1:O'~' lD.I~tO>l ~1Q1!5 TliL i'lJ'Tl.4 ",~-"'..,a; <br /> <br />1-m nzlO. p-m <br />Q~F'il4 <br /> <br />- <br /> <br />ADDITIONAl. Il\lSURED iNOOFlSEMiNT <br /> <br />Insurancl Company .l!:It. 1:0..,,1 Fi r... ... "._h_ <br /> <br />.~ <br /> <br />Tl'II! endorse:neJ'lI IMcll\lll uvr;h In,unmce III ~ allordeo by 11111 prov!Ii9/11 of Policy <br />" TEOOBOl 929 filiating to thD fo1lOl"1II9! <br /> <br />1. 'The 01~ 01 sanlCl AAlI, :20 eMc Clnllr I"l~., S Irllll An.. Callfarnia eZ79'; <br />11< offic.~", .mplgy~, agenlS 8IId r,pronnlallll81 art natMcl u -.tQldonai iNlurtGI, <br />('oddillonlll InlU..dll'"l with rogllrd 10 r"birlly and da'e".' Of eu~, erl,'n" ft'om lh. <br />o,lI18tiOns .nd u..$ pdl'mtd by Clr' on btnll1 ClllhB namec:l inliUred. <br /> <br />2. V.'rh r.sp,'" 10 clllml "'''''g ou! or lhcl operello rill "rid us.. perfvrrned ~ <br />or Qn behalr of tha nllmlCllnlUlfd,lIlJClh !nil""""" i!lI!IlQralld b)' !his pOlicy i. prim"", <br />.rld I, rIOl t<!clllgnal tQ or conltlbU~ng will'l ""' other 1n8IJr8I'IC::I clfl'l.of oy or 'or the <br />benlnl Dr 1111 l!dlll~Qnlli 1(l1l1ll'1Id1. <br /> <br />3. Tnill Ins,",rance llPpli.. UllperlU!l~ 10 .acl\ Insured 811linOi wl1Qm claim Is <br />"lid. Dr .ui\ i$ brcugm ll>lCI~1 w\lII r~ 10 Ine comP/lrl'{f !Imts Of llabili~. 11'le <br />i ,l;lWl;ion of any person or or~..ticn as an Insur"d ,II~I not affect any rlghl wl'llct1lll,lch <br />p.r50l1 or QrglnlEII~on would ttav0 II . ctalmj(ll il flot SO Incllold,d. <br /> <br />4. With r"PIClt 1.0 il'\B lIOdItIon.1 inS\lrlldl, Wi inwranCla shall n;lt be olnC9llMl. <br />';II' ma18rll,lIy r.dUCl~1l if' oovarlg8 Qt' .mill _eepl ,f:ar thirty (!Ol daya wri'mln 1'101108 ha, <br />i;lllln IIl1/ln 10 the City of Strlll~. 20 Ci'vio Cenler PIUII. Sirlll AI'lll. C.'dornla 827Q1. <br /> <br />(Compl;lllon or thalollowlnB. i"elllding eOUnler8111n.tllr~ \I required to ",akl mls <br />mllerl'mlnt ellllOllVt,) <br /> <br />Effegjlv,OS/27lJJ 4 <br />policy #: 'rE0080U2!l <br /> <br />1 thl& .ndotUm,nl Torm u. pan 01 <br /> <br />l.alJ"d to llak",ma ~rn~\~. 'rota <br />!'Ilmel! (nau..- <br /> <br />cQllntar,illn"d by <br /> <br /> <br />APPROV'Pp A81'Q rC:'\i'''' <br /> <br />.'---". <br /> <br />~r. 'HleCdY <br /> <br />Allittant C,lY A<IOrn.Y. <br /> <br />~8 38\td <br /> <br />SClAS O.:lNI I:'~Cl <br /> <br />981>~-LI>9-1>1L <br /> <br />~E:P, ~88~/1>1/68 <br /> <br />