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<br />...WI ",/411t!.UUtJ '.I.'lMel 4109 PM TOl Ghiz-;i. Mario It 17146475421 <br /> <br />. <br /> <br />1-510-452-2193 <br /> <br />Pa~-el 003 003 <br /> <br />, <br /> <br />Policy Number: BKOI89589:: <br /> <br />Owners)... Lessees or Contractors (Form B) <br />ADDITluNAL INSURED <br /> <br />Change(s) Effective: 03/27/(16 <br /> <br />THIS ENDORSEMENT CI-IANI3ES THE POLICY. PLEASE REAl) IT <br />CAREFULLY. This endomem" nt modifies insurance policy under Ihe following: <br /> <br />LIABILITY COVERAGE PART: <br /> <br />Name of Person or Orgal1lzation: <br /> <br />City of Santa Ana <br />Building MaintenanCE! D:. vision <br />Attn: Mr. Mario Ghizzi <br />20 Civic Center Pla~:a, ~-11 <br />PO Box 1988 <br />Santa Ana, CA 9270~! <br /> <br />Schedule <br /> <br />SECTION II - WHO IS AN INSlIRED is amended to include as an il1sured the <br />person or organization shown 'n the Schedule, but only with respect to liability <br />arising out of .your worn" for t"E,t insured by or for you. <br /> <br />City of Santa Ana, its officers, agents, volunteers and <br />representatives are nar:1ed as an additional insun,cl as respects genercl <br />liability for claims al~:Lsing from the operations elf the named insurec.. <br /> <br />PRIMARY INSURANCE: <br />IT IS UNDERSTOOD AND AClEEED THAT THIS INSURANCE H PRIMARY <br />AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIOtiAL INSURED <br />SHALL BE EXCESS ONLY AlJD NOT CONTRIBUTING WITH THIS <br />INSURANCE. <br /> <br />SEVERABILITY OF INTEI:<EI;T: <br />IT IS AGREED THAT EXCEP'I' WITH RESPECT TO THE LIMIT OF INSURANCE. THIS <br />COVERAGE SHALL APPLY AB IF EACH ADDITIONAL INSURED WERE THE ONLY INSUR;:D <br />AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAn! IS MADE OR SUIT IS <br />BROUGHT. <br /> <br />WAIVER OF SUBROGATION: <br />IT IS UNDERSTOOD AND AClRE:ED THAT THE COMPANY WAIVE,; THE RIGHT OF <br />SUBROGATION AGAINST THE "'BOVE ADDITIONAL INSURED'SI, BUT ONLY AS RESPECT:; <br />THE JOB OR PREMISES DEt;CRIBED IN THE CERTIFICATE A'rTACHED HERETO. <br /> <br />~ ;;2./2 <br /> <br />CUBF 22 40 03 95 <br />