CALIFORNIA, STATE OF EMPLOYMENT DEVELOPMENT DEPARTMENT

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ENDORSEMENT This End orsementChanges the Policy -Please Read it Carefully PRIMARYAND NON-CONTRIBUTING INSURANCE (Third-Party's Sole Negligence) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART OWNERS AN D CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART RAILROAD LIABILITY COVERAGE PART BUSINESSOWNERS LIABILITY COVERAGE FORM The following is added to Section IV - Commercial General Liability Conditions, Paragraph 4: Section IV: Commercial General Liability Conditions 4. Other Insurance: d. Notwithstanding the provisions of sub -paragraphs a, b, and c of this paragraph 4, with I the Third Party shown below, it is understood and agreed that in the event of a claim or arising out of the Named Insured's sole negligence, this insurance shall be primary and insurance maintained by the additional insured named as the Third Party below shall be and non-contributory. The Third Party to whom this endorsement applies is: THE CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES AGENTS AND VOLUNTEERS 20 CIVIC CENTER PLAZA SANTA ANA, CA 92702 Absence of a specifically named Third Party above means thatthe provisions of this endorsement apply "as required by written contractual agreementwith any Third party for whom you are performing work." All other terms and conditions of this policy remain unchanged. to This endorsement Is effective on the inception date of the policy unless otherwise stated herein. ke information below is required only when this endorsement is issued subsequent to preparation } the policy.) q Policy Number: CIP351907001 Named Insured: COLLEGE OF INSTRUMENT TECHNOLOGY Endorsement Effective Date: Endorsem ant Serial No. AF 001 397 0712 Includes copyrighted m starlet of Insurance Services Office, Inc, with Its perm ission Copyright, Insurance Services office, Inc. 1994