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LIEN ON ME 1 - 2000
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LIEN ON ME 1 - 2000
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Last modified
3/27/2017 2:45:27 PM
Creation date
3/28/2006 7:53:15 AM
Metadata
Fields
Template:
Contracts
Company Name
Lien on Me, Inc.
Contract #
A-2000-141
Agency
Personnel Services
Council Approval Date
8/21/2000
Insurance Exp Date
8/15/2007
Notes
Workers' Comp expires 06/01/08
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<br />. 10/09/2001 09:45 <br /> <br />97.30512. <br /> <br />COLONIAL S BAY 4iIl <br /> <br />PAGE 02 <br /> <br />ADDITIONAL INSURED ENDORSEMENT <br /> <br />-. <br /> <br />In&urance ComPllny <br /> <br />TUDOR INSURANCE, CO, <br /> <br />Th'~88l'$ement modifies such infurilllCe as i5 atfOl'ded by the provl&ions of PoIicV <br />1# 05500 relating to 1he following: <br /> <br />1. The City of Santa Ana, 20 Civic Center Plaza, San1ll Ana, California <br />92701; Ita officerlJ, emplove-. agents. volunteers aM repr.entatiWl6 .... named as <br />. additional infIu~. ("additiomll Insureds.) with regerd to liabUity ,nd defenH of &uib <br />,riting from the operation. and IIMS performed by or on benaII' of the named ineured. <br /> <br />2. With reepltat to c1llime wing out of the operations and uses perfom'led by <br />or on behalf of the named inaured. aucn insurllnce II. ;. afforded by tNl policy is <br />primary and is not additional to OJ contributing with any other inlIurllflCfl oarried by or for <br />the benefit of the QOdilional inSiJreds. <br /> <br />3. This lnsuranee aPIIlies aeparatl!!1y to ..eIl insured against whom claim' is <br />ITIlIde or lluit iI'brought except with respect to the company's limlt$ of liability. The <br />inolualon of any person or organization at an inaur.d IIhl" not affect any right which <br />such p4lrson or organization wOuld have iI& a claimant if not so included, <br /> <br />"-"" t, <br /> <br />" <br /> <br />If. With I8$pect to the additiOnal inlutlKll, \t1i8 i~uran~ ohan not be <br />cancelled, or materially reduc&<l in CQ\Ierag8 Dr limi\$ 811cept after thirty (30) dayS written <br />notiCl!l has been giVen to the City of Silnt'" An.. 20 Civic Center Plaza. Santa Ana, <br />California 92701 . <br /> <br />" <br /> <br />(Completion of the following, incJuding countersignature. is required to m.ki this <br />endolll4lment .ffective ) <br /> <br />Efteclwe 3~25-01 <br />poucy # ilf:LO O-.O.S.S 0 0 .___ <br />l$SOlIed lo~. LIEN ON M.!i!....._!llli.o_ <br /> <br />.Ihis endorsement form as II plJrt of <br /> <br />--.- <br />Named 11l6ured -- <br /> <br /> <br />C__.......by ~ ~ " <br />1.:..../ ~i1tcl epresentative <br /> <br />, <br /> <br />'-' <br /> <br />01 <br />
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