Laserfiche WebLink
01/2012011 02:03 FA}{ 71A4381005 <br />.ter-1e-i-crs-?ra1 j y-t= Jb r rom: <br />Toe7144381.005 Paar:3?3 <br />POLICY NUMBt=R: 50469-65-12 13USINEBgOWNE/tS <br />EFFECTIVE DATE: 11/'!7/290 BI> Q4 67 Oi 97 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY_ <br />ADDITIONAL INSURED -OWNERS, LESSEES OR <br />CONTRACTORS -- WITH ADDITIONAL INSURED <br />REQUIREMENT IN CONSTRUCTION CONTRACT <br />This endorsement modifies insuranpe provided under the following: <br />BUSINESSOWNEI2S POLICY <br />INSURED- <br />The tolbwing is added to Paragraph G. Wt?o Is An SPECIALTY ENVIRONMENTS CO: <br />Instenld in the Businessowners Liablllty CoVgrage <br />Form: <br />4_ Any person or organizatlon Tor whom you are <br />performing operatlOns is also an insurod, If you <br />and suoh parson or arganizatlon have agreed In <br />writing in a contract or agreement that such person <br />or organization ba included as an additional <br />Ensured on your policy. Such person or organization <br />is an additipnaE insured only with respe4t to liability <br />arising out of your ongoing operetiona performed <br />far that insured. A person's or organEzation`a str?tua as <br />an Insured tender this paragraph ands whCh your <br />operatlans for that Ensured mre Completed or the <br />contractor's a?groement is terminated. <br />NAME OF PERSON QR ORCiAhEIZATlON <br />T'iiE CITY OF SANTA ANA <br />20 CIVIC CENTER PLALA <br />SANTA ANA, CA 92702 <br />IT'S OFFECERS, EMPLOYE!=S, AC3ENTS, <br />AND Vd?UNTEERS ARE !NAMED AS <br />ADpIT10NAL INSUREDS <br />gpPR?S???(D ?' TQ FOR`y.---- <br />pss`s? t C1tY Attorr?eY <br />?? <br />13P O4 B7 t7't 97 Copyright, Insurance Services Office, Inc., 1987 Page 7 of 7 O