Laserfiche WebLink
<br />'-' <br /> <br />POLICY ENDORSEMENT # 02 <br /> <br />Insured copy <br /> <br />'..., <br /> <br />This Endorsement is Attached to and made part of Policy # CLS0821548 <br /> <br />Issued to: SANTA ANA BOXING CLUB <br /> <br />Agent: ISU INS SVCS/FULLERTON INSURAI <br /> <br />Insurance Company: Scottsdale Insurance Company <br /> <br />Producer: Yates & Associates Insurance Service <br /> <br />Effective date of this Endorsement is 9125/02 at 12:01 AM Standard Time. <br /> <br />X Additionallnsured(s) <br />X Forms Added <br /> <br />In consideration of an additional premium of $450.00 (fully eamed), it is hereby agreed that the following additional insured is made <br />part of the policy perfonm "Additional insured Endorsement For Commercial General Liability Policy" attached. <br /> <br />THE COMMUNITY REDEVELOPMENT AGENCY, <br />THE CITY OF SANTA ANA, <br />ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS <br />AND REPRESENTATIVES <br />20 CIVIC CENTER PLAZA <br />SANTA ANA ,CA 92701 <br /> <br />All other Terms and Conditions remain the same. <br /> <br />An .<OV 1::.0 AS fO FORM <br /> <br />/6!~~ <br />I-aura Sheedy <br />kpulY City Attorney <br /> <br />Issue Date: 10/4102 <br />/7 J <br />I!.~ /. <br />Issued By: ~ <br />&!mpany Representative <br /> <br />Other - shown above <br />Braker Fee <br />Policyllnspection Fee <br />State Tax <br />Stamp Fee <br /> <br />Total <br /> <br />/ ' .0 <br />/?_:;'-'cffU/tu./ <br />d I <br /> <br />450.00 <br />0.00 <br />0.00 <br />13.50 <br />1.13 <br />464.63 <br />