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FIESTA DE CARNIVAL (A-2015-188-01)
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FIESTA DE CARNIVAL (A-2015-188-01)
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Last modified
3/27/2020 9:30:34 AM
Creation date
3/8/2016 10:19:24 AM
Metadata
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Template:
Contracts
Company Name
FIESTA DE CARNIVAL
Contract #
A-2015-188-01
Agency
PARKS, RECREATION, & COMMUNITY SERVICES
Expiration Date
2/2/2017
Insurance Exp Date
5/27/2017
Destruction Year
2022
Notes
A-2015-019; A-2015-188
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REACT IT CAREFULLY, <br />POLICY CHANGES <br />Policy Change <br />Number s <br />POLICY NUMBER <br />POLICY CHANGES <br />COMPANY <br />FPG200'I'1734-02 <br />EFFECTIVE <br />Essex Insurance Company <br />p y <br />9/3/15 <br />NAMED INSURED <br />AUTHORIZED REPRESENTATIVE <br />International Promotions, Inc, DBA: Fiesta De Carnival <br />Greg Thompson <br />11278 Los Alamitos Blvd #101 <br />Los Alamitos, CA 90720 <br />COVERAGE PARTS AFFECTED <br />Commercial General Liability Coverage Part <br />CHANGES <br />It is hereby agreed that the following Additional Insured Is added: <br />City of Santa Ana; Parks, Recreation & Community Services Agency <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />Form # CG 20 26 04 13 <br />Description -Additional Insured -Designated Person or Organization ?1e <br />Form # MEGL 0010 0311 <br />e60" <br />Description -Additional Insured - Primary and Non Contributory <br />.0 (I <br />ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. <br />CJt� <br />PRGs <br />Authorized Representative Signature <br />IL 12 01 11185 Copyright, Insurance Services Office, Inc, 1983 Page 1 of 1 <br />
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