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•-J �1. 1110 aerrano H ana a Hospital <br />Oot 27 03 Olt44p Isnta Ana 200 <br />ADDITIONAL INSURED ENDORSEMENT <br />949 855 1070 p_4 <br />7i41537401 p,3 <br />lnsurance Company: F f 2 E M/+ it1.'S Ff f ,y � 114 S &. <br />Thi%clidorsemeot modifies such insurance : s in niforded by the provisions of Policy # AZ C too ,Z <br />Relating to the following: <br />1. *ML, City of Santa Ana, 20 Civic Center Plaza, Narita Ana, California'y27111, <br />officers, employees, agents anti repnwntativm are named as additional insorml <br />with regard to liability and defense of suits at ising from the operations and usin <br />parformoJ by on behalf of the named insured, <br />2. With respnrt to claims arising out of the operations and uses performed by or on <br />behalf of the named insured, such insurance as is afforded by this policy is <br />Primary and is not to contributing with any other insurance carried by or for the <br />benefit of the addillonal insured. <br />3, This insurance applies suparahfly, to each insured agaimsl whom claim is made or <br />suit is brought except with respect to the company' n litttlts of liability. The <br />inclusion of any person or organization as an insured shall not affect any right <br />which such person or organization would have as a claimant if not so included. <br />A. With respect to the additional insured, this irtsuram-e shall not tie cancelled, or <br />nmh:rially reduced in coverage or limits excopt after thirty-30 days written notice. <br />has given to the City of Santa Ana, 20 Civic Center Plain, b*%nla Ana, Colifurnia <br />92701. <br />Completion of the following, including eounterstb'nature, is toquircd to make this <br />endorsement affective, <br />L•'ffectivc 7 _ f _ C 3 this endorsement form as part of <br />Policy # A Z t^ 2U 7.3 7 6 / (o <br />Issued to Se2klf4=c Ar)rf-r4L t- /3iRe� /�oSf Sti'C <br />NamM Insures <br />Countersigoed by <br />oa/IF/v7 <br />