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a <br />ri~V 13 2003 11: 17RM HP LflSERJET 3200 <br />POllcy NUmber: HK01237606 <br />owners Lessees or Contractors (Form B) <br />ADDITIbNAL INSURED <br />Change(s) Effective: 10/31/03 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT <br />CAREFULLY. This endorsement mod'rf'ies insurance policy under the following: <br />LIABILITY COVERAGE PART: <br />Name of Person or Or®anlzation: <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />Schedule <br />SECTION II - WHO IS AN INSURED is amended to include as an insured the <br />person or organization shown in the Schedule, but only with respect to liability <br />wising out of "your work" for that insured by or for you, <br />City of Santa Ana, its officers, agents, volunteers and employees are <br />named as additional insured as respects general liability for claims <br />arising from the operations of the named insured. <br />PRIMARY INSURANCE: <br />IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY <br />AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED <br />SHALL BE EXCESS ONLY AN'D NOT CONTRIBUTING WITH THIS <br />INSURANCE. <br />p.2 <br />SEVERABILITY OF INTEREST: <br />IT IS AGREED THAT EXCEPT W?TH RESPECT TO THE LIMIT OF INSURANCE, THIS <br />COVERAGE SHALL APPLY AS IF EACH ADDITIONAL INSURED WERE THE ONLY INSURED <br />AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAIM IS MADE OR SUIT I3 <br />BROUGHT. <br />~~~ ~~Z <br /> <br />CUBF 22 40 03 95 <br />