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LIEN ON ME 2 - 2006
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LIEN ON ME 2 - 2006
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Last modified
11/8/2017 10:20:57 AM
Creation date
5/26/2006 12:26:06 PM
Metadata
Fields
Template:
Contracts
Company Name
Lien On Me
Contract #
A-2006-112
Agency
Personnel Services
Council Approval Date
5/1/2006
Insurance Exp Date
8/15/2018
Notes
Workers' Comp expires 06/01/09
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10/30/2U06 MON 16:34 FAX <br />10/31/2005 12:09 FAT: 213 707 1167 <br />ADA1' 0NAL fKSURED ENMRMMF'NT <br />Q004l004 <br />IM002/002 <br />ipsarto.ct Cge,p.,ty, The Hartford <br />r� <br />n <br />Both In2ursace $3 b afford d by the protons of poky <br />142#91;2"&le It Maes <br />7 6145 re)adng to Bile fellowiags <br />`.__ <br />' I: 'tbe City of Sesta Aoy Z0 Gtilric Caatr 11ea Sawla Aei_ Califsrrria <br />_ <br />1=701: we offla s, empteyees, syenby.oemtwm=d roprratmurivas are asm" m- <br />ad"aaal inaartd3 ("addeieual insureds") wM relarAm to fiabtlay abd ddtM of <br />.- .. <br />eoim araimc from 99v aaershhus aed sea perfetwmd byur bebalf of tot palmi <br />iaaarad- <br />�'- <br />L Whit re$pm to claims arbMS oat of the operatives and um ra performed <br />by or ori brAAf of the Maned blared, Be& iosarnmee a i. Mrded by this poNry is <br />primarr and is not additiamli le or eoatribadpa with any stbaritlfera+alGoaniddby <br />or fortlte behaKofthv additional luawrad. <br />3. Thi! fasa►aaee appifeaseparatefy m tecta iesered te®rivst ahem tiiaisr i! <br />made or Bair fa brvw0t lraccpt with respect b tit ceorpaay'e !irate of xability 7 be <br />iaelosloe of any person or orpni mbli 47 u isavred vW tot WSW two right <br />whhdl aaeb person or e. aaaiv4la would hareas a dnimmt it nor so hKmdr& <br />d. Wilk respout tv the 11490 anal ioirroda, Shim insurance shall not be <br />cancelled, or mabianny reduced in coverage or Umits amopt after thirty (36) day -F <br />.Tawe batiteeaa been Vjvtn to tba Ctly of Santa Ass, 20 C"mit coTwr Plana Santa <br />!,na raMerpct 92703_ <br />(Complattan orthe totiomr,& 4 rageir'ed to ma41! tpir <br />andortamerrt etreefty .) <br />Eif=&c 51 �Shla CadOr/lk0lht;9rnF ai pal) Of <br />Policy M- <br />Ie3aad to I+ea On M Ina <br />Covatesvigaed Byi <br />�eLeri�albfmflnra:hY <br />APPRUI'i,_j U FUld: t <br />•�••��•fa�ll �:il) 1i 1� r:Cl� <br />4'd 92TT--TZ6 I9Z91 sgooet. yauer e6T°Tl 90 4Z too <br />
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