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<br />818-790-5305 tlEN ON ME <br /> <br />INC <br /> <br />35W02 <br /> <br />RUG 15'00 09:59 <br /> <br />".- <br /> <br />ADDITIONAL INSURED ENDORSEMENT <br />FOR COMMERCIAL GENERAL LIABILITY POLICY <br /> <br />Insurance Company The Hartford <br /> <br />This endorsement modifies such insurance as is afforded by the provisions of Policy <br /># 7 2SBAGA] 988DX relating to the following: <br /> <br />I. The City of Santa Ana,:20 Civic Center Plaza, Santa Ana., California 92701; its <br />officers, employees, agents, volunteers and representatives are named as additional insureds <br />("additional insureds") with regard to liability and defense of suits arising from the operations <br />and uses performed by or on behalf (}f the named in.<:c;rec. <br /> <br />2. With respect to claims arising out of the operations and uses performed by or on <br />behalf of the named insured, such insurance as is afforded by this policy is primary and is not <br />additional to or contributing with any other insurance carried by or for the benefit of the <br />additional insureds. <br /> <br />3. This insurance applies separately to each insured against whom claim is made or <br />suit is brought except with respect to the company's limits ofliability. The inclusion of any <br />person or organization as an insured shall not affect any right which such person or organization <br />would have as a claimant ifnot so included. <br /> <br />4. With respect to the additional insureds, this insurance shall not be cancelled, or <br />materially reduced in coverage or limits except after thirty (30) days written notice has been <br />given to the City of Santa Ana., 20 Civic Center Plaza., Santa Ana., California 92701. <br /> <br />(Completion of the following, including countersignature, is required to make this endorsement <br />effective.) <br /> <br />Effective <br />Policy # <br />Issued to <br /> <br />OS-l'i-?()()() <br />72SBAGA19SSDX <br />Lien On tole I Inc. <br /> <br />- <br />= <br />=> <br />, this endorsement form as a part of <br />:-:->- <br />c: <br />G> <br /> <br />Named Insured <br /> <br />I):) <br /> <br />.....-, <br /> <br />J> <br /> <br />Countersigned by ~I'\ :: ~ Q ~ . <br />Authorized Representative <br /> <br />f';Y <br />GJ <br />CD <br /> <br />~~'j,. . <br />~;:'~ <br />:::;::..'" <br /> <br />t:"~, <br /><'Cj,,>.F <br /> <br />EXHffiIT C <br /> <br />APPROVED AS TO FORM <br /> <br />R.ECEIVED <br /> <br />/.., <br />-F ( 'j j <br />(..J./:i() ;..)'.LJ'C('1C(/ <br />. "v......'j, ,/,_.-\ . <br />"Laura She~dy <br />Deputy City Attorney <br /> <br />9 <br /> <br />AUG 1 6 2000 <br /> <br />LIEN ON ME, INC. <br /> <br />f1 f../ / if' <br />il'" i ;/' <br />