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<br />POLICY ENDORSEMENT # Y <br />s Endorsement is Attached to and made part of Policy # 2AEB540 <br />Insurance Company: ESSEX INSURANCE COMPANY <br />Effedive Date of t~1is Endorsement is 01/10/99 at 12:41 AM. <br />P.4i6 <br />lnsumd's COPY <br />Issued to: SOUTHLAND ECONOMIC <br />Agent: BRAKKE.-SCHAFNITZ INSURANCE <br />In consideration o~' the premium below, it is hereby agreed that the Policy is amended. as respects the <br />fopowtng items: <br />[ ] 1. Rate j j 7. Expiration Date <br />[ ] 2. Premium [ j 8. Name of Insured j j 13. Classification <br />[ j 3. Premium Bases [ j 14. Location <br />j j 4 Coverage { j 9_ Maifng Address [ j 15. Mortgagee <br />[ j 10. Cancellation [ j 16. Audit <br />j j 5. Cover-Note [ j 1 i_ Reinstatement <br />[ j 6. Incep on Date - [ j 17. Forms Added <br />. [XJ 12. Additional Insured. [)() 18. See Balow <br />>T IS AGREED TF~AT COMMERCIAL GENERAL LIABILITY COVERAGE PART SUPPLEMENTAL DECLARATIONS -FORMS AND <br />ENDORSEMENT$ - IS AMENpEO TO INCLUDE M/EOQ9(3/95) ADDfT10NAL INSURED IN FAVOR OF: CITY OF SANTA ANA_ <br />SEE FORM ATl'At;HED. <br />All other Terms and Conditions remain the same_ <br /> <br />ssue Date: 10/1 <br />°~~~d By_ <br />Com ~ <br />CLEIN 8, COSTA[ <br />E SERVICES <br />Additional Premium°^ 0.00 <br />Other -shown above 500.G0 <br />-~. Broker Fee 0.00 <br />Inspection 0.00 <br />State Tax ~ 5.CC <br />Stamp Fee 1.75 <br />Total 516.75 <br />