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1i:-09-03 10:09AM FROM-RRM Dasian IV 805-543-4609 • T-941 P-002/002 F-595 <br />Policy Number: <br />BK01571071 <br />Owners Lessees or Contractors (Form B) <br />ADDITIbNAL INSURED <br />Change(s) Effective: 11/21/03 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT <br />CAREFULLY. This endorsement modifies insurance policy under the following: <br />LIABILITY COVERAGE PART: <br />Schedule <br />Name of Person or Organization: <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <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 />arising out of "your work" for that insured by or for you. <br />City of Santa Ana, its officers, agents, volunteers and employee3 are <br />named as additional insured as respects general liability for cl.3_ms <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 AND NOT CONTRIBUTING WITH 'PHIS <br />INSURANCE. <br />SEVEPABILITY OF INTEREST: <br />IT IS AGREED THAT EXCEPT WITH RESPECT TO THE LIMIT OF INSURANCE, 'HIS <br />COVERAGE SHALL APPLY AS IF EACH ADDITIONAL INSURED WERE THE ONLY ;NSURED <br />AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAIM IS MADE OR SUI`' IS <br />BROUGHT. <br />NOTICE OF CANCELLATION: <br />IT IS UNDERSTOOD AND AGREED THAT IN THE EVENT OF CANCELLATION OF 'HE <br />POLICY FOR ANY REASON OTHER THAN NON-PAYMENT OF PREMIUM, 30 DAYS <br />WRITTEN NOTICE WILL BE SENT TO THE CERTIFICATE HOLDER BY MAIL. _r THE <br />EVENT THE POLICY IS CANCELLED FOR NON-PAYMENT OF PREMIUM, 10 DAYS <br />WRITTEN NOTICE WILL BE SENT TO THE ABOVE. <br />`r CL/BF 22 40 03 95 <br />