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Dec 04 03 10:44a HOUston&HarrisPCS 9094220841 p.3 <br />ACP 6tNM ICATES Fax:909-8B6-0053 Dec 2 2003 13:30 P.02 <br />0EC. 1. NO 12:58PN N0. 776 P. 2 — <br />Filelaan3 <br />Fond <br />POLICY NIA R 3 17 IMX E02153 7e <br />.Named Itmteed 9equadw Eadotsemeol Number 006 - <br />SOUSTON a EARRIS PCs, 2NC - <br />. PORTFOLIO C{AWE ENDORSEMMT <br />E£fsctiom 11/20/03, 12:01 A.M., - <br />&teadar2 Time at the address of the insured <br />-This is as 3dorsement only: Dthar than changes shown, ail ot2ier Pre-e:ist±ng <br />cove,rage remains in full -.area and affect. -Premium adjuaw=a..6 are shown. <br />PREIGUY3U20L%RT' - aDLM2Dlta7. PRIDgm[ DD3 -jMN USS-00 <br />Terrorism R1sY Insurance act -Certified Act, Oo►erage - <br />Alleceeragea oval wC - Net Cewessd - $0.00 <br />Includes CALIFORN--A Surcharge of $5.00 <br />The 2remium shown includes Adjus=able PreVUUW(3). Re=er to PremiUM Adjustment- - <br />Inforoacion attached. <br />The following other General Liability esdersement-ie)-are added to toe police - <br />- and app17 se shown: - - - - <br />ADDITIONAL INSURED 3 DOR93MENT <br />- 1E0009 0669 - - - <br />INSURANCS COMPAN-': NATIONAL. 31JR"TY CORPORATION <br />TRIS ENnOR.4EMNT MODIFIES 67CH INSURANCE AF IS AFFORDED BY THE - <br />PROVISIONS OF POLICY aMZX E0E1.E37a RELATING TO THE FOLLOW=M: <br />1. Tn CITY OF SANTA APA, 20 CIVIC CENTER ?LAM, 6ANTA AEA, <br />CALIFORNIA 92701r :TS OFFTCERS, EMPLOYEES, AGENTS AND <br />R2PFBSSNTATIVES ARE NAMED AS ADDITIONAL INSM?D9(*ADDITIONA:, <br />INSU=5*) WITH REGARDTOL3ABIL27Y-AND DEFENSE OF SUITS <br />AR-7 SING FROM THE OPEWATIONS AND USES PERE'ORMED BY OR ON <br />BE AL7 OF TFM DAY.ID TNSURED'. - <br />2. WITR RBSp= TO LiAnts ARISING auT OF TIa OPERATIONS AIM <br />USES PER}02HXD BY OR OR BESALay OF Tim HAM INSURED, EIICII - <br />INSURANCE As 25 AFFORDED BY THIS POLICY 15 PREIMARY AND IS <br />NOT ALDITIORA_, TO OR CONTRIBDTINO WITH ANY DTRE& INSORANCE <br />CARRIED BY OR FOR THE BamrIT OF TIM AVDITIOIfAL INSMEDS. <br />J. TRIG INSORANCE APPLIES SEPARATELY TO EACH INSURED AGAINST - <br />WFOM CLAIM IS MELDS OR SOTT IS EROUGRT EXCEPT WITH RESPECS' - <br />coaete stSOAtse - of AOthorizc4 Agent: - Des il/21/03 <br />Rodnra AU5T1N COOPB2 a FR2CE tvVVL�7�"fd"' AGENcY, INc. _ <br />Y.O. BOX 3290 - <br />SAN BEEA7aRDINO CA 92+•13 - <br />CHANGE ENDOR.StMEN'T cornNOF.D ON. PAGE 2 <br />Page 1 <br />A3 pjWVE + AS iCl FORM <br />iat shcedy_ <br />�- Deputy City Attornev - - - <br />