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LOPEZ, RAFAEL 1
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LOPEZ, RAFAEL 1
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Last modified
5/28/2015 10:09:22 AM
Creation date
6/26/2003 3:27:38 PM
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Contracts
Company Name
Rafael Lopez
Contract #
N-2003-057
Agency
Parks, Recreation, & Community Services
Expiration Date
10/31/2003
Insurance Exp Date
10/22/2003
Destruction Year
2010
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04104/2003 13:46 734 -554 -5134 <br />n &r 91 03 .rri!!P <br />PUBTC 4UTr1 PtESTSTre <br />lnturaccc(;wa,Yan:` <br />This endotaelr nt mudifies such roam rntee as is afforded b3 the provisionz of F:,bcq <br />fi _-, 4;�,fyZ��±l, l.rclatin� to the foilowing <br />I. IN Ciro of Santa Ana, 20 t;ivc ( .meter Rua. 5mttn ara, Cai:farni 9270; i itn <br />02,"m. eniployaes, agedts, volunteers and rwiresentatives arc noint(l u5 o tiitiapw insureds <br />(" additiona) nsureds") with regard to!iahility and datonse 04 slf,% arising tro» the operation; <br />and uses performed by or on behalf of ilic named ;rtsu;ed. <br />2 Witb respect tt, aaims ariaiag out of the ope:at:ors anu am pGff rnned by or a: <br />behalf 'ofthe naaned insured, such luirwe as is afforded by ties policy is mmptwry and is rut <br />additional to ur cnnlribawig with any other in.wance carried av or fat r1w t >eacrm of thv <br />addition trmirtnls. <br />;t, Ilms it:auranee apybus bulfwalely to each Insured ag& :Q31 Whom claim is made or <br />mull Is brought except with respect in rite usimpanys limits of h &bility The inc)us,an oi' Any <br />rerson Of o:ganirmtivn Ya an irksoml shtll twt affect any tight which such pers<91 t't of janiration <br />Would have as a claimant if cot so imlorin,l. <br />4, With reapecl to the additional iasureds, this insurance shall IN he esitce'.;od, or <br />maeerially reduced it) covctag0 or iirn b axcepl sfterthirly M) Jays wn�wtt twtice has been <br />Oven ,n the City of SOMA Anti. 20 Civic Center Plana, Se vte Ana. C ai4O;Ax U101, <br />(Completion of Ilse :'Allowing, includilig woxtler&tOsnaturc, is required to mike this rndmsemen! <br />IaLkctive o Q 03 s _.. - - -_ - --- ihis cedctserncm form as a "ore :,f <br />Policy rj7x�- _�"9.S <br />Named Insured <br />Cowtersiitn od b - <br />!~- i <br />pit zed Rcertesentat!ve <br />l" <br />AS ro r,ORA4 <br />, �,ulv Citv Artomev <br />PAGE 04 <br />
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