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<br />r <br /> <br />, <br /> <br />HP . ~ERJET 3200 <br />'-' <br /> <br />"'" <br />5..!>. 1119 2Ill1I2 1113: I1I7f'M P4 <br /> <br />, <br />SSP 16 2002 9:48AM <br /> <br />FAX NO. :714-547-5549 <br /> <br />F)'<OM <br /> <br />e.DDI~IONAL INSlIRED ENDORSEMENT <br />E9j...QQ.~MERCIAL GENERAL UABIl.lTY POLlCY <br /> <br />Insurancc ComponyY'i\\ \0 ~{\~ ,\\,l^, \n d,(,\'l'\ (\ i N ~D~ \l cJ.; ~m ~a yt ~ <br /> <br />This ondorsemcnl nUldilies such insurunce lIS is afforded by tbe provisi(lns of Policy <br /># 1'm>V-W1515 relating to the following: <br /> <br />1. Tbe City Dr 8011\1\ Ana, 20 Civic Center Plaza. SlII1ta Ana, CalHbmi<l 92701; ilS <br />off1ecrs, employees, agents, vohmtcers and representatives are named as addi\iClllal insureds <br />("odditiona\ insureds") with regard to liahility and defense ohllit. arisillg from the operations <br />Dnd \I5CS porformed by or on behalf of thc named insllred. <br /> <br />2. With respect to claims arising out of the opcrations and uses perfo\1ll.d by Of on <br />bchalf oftlle nN'lled il\SUrcd, slIch insurance as is aftbrdod by this policy is primary and is not <br />auditionallo or eontributitlg with llny other in,urance can'led by or for the benefit of Ihe <br />ndditiol18l insureds. <br /> <br />3. This insurance "pplies sepautel)! to each insured against whom claim is made or <br />suit is brought except with respcct \0 tbe company's limit. (If liability. The inclusion of any <br />p~rsoll or Qrganization lIS all in~\ll'ed shall not ll!'t'olct any right which S\leh person or orsanil'-lllion <br />would nllve Il~ a claimant ifnot so included. <br /> <br />4. With respect 10 Ihe additional insured., thi~ insurlUlCt1 shall not be cllncelled, ur <br />mat.riDlly reduced in Cllverage or limits eKcept after tllirly (30) days written nolice has been <br />givon to the City of Santa Ana. 20 Civic Center Plaza, Santa Ana, California 92701. <br /> <br />(Completion of the following, including countersJgnature, is required to make this endorsement <br />elrective.) <br /> <br />Effective 01 -01 - UX>Z- .~t'lA 01 -DI - ~ tbis endorsement form as a part of <br /> <br />Policy # ~~ d.lHit.-... .---- <br />I:;'<\led to 1'1 .p, Y\ -.. <br />N aroed Insured <br /> <br />Countersigned by <br /> <br />~~ <br />Authorized Rep l~-i~~-r;-- <br /> <br /> <br />p.2 <br />