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<br />Jun 2105 11:15a <br />. JUN-02-2005 ag:42 <br /> <br />Public Works <br /> <br />7148473345 <br /> <br />~DREINJ AND CO <br /> <br />POLlCY NUMBER: TCP2068975201 COMMERCIAL GENERAL LIABILITY <br />INSURED: CLINICAllABORA TORIES OF SAN BERNARDINO. INC. <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHt:.DULE <br /> <br />Nilme 0' Person or OrganlZlltlon: <br /> <br />city of Santa Ana <br />Water Resource blv., M..sf <br /> <br />If no entry appears above. information required to complete this endorsement will be sllown in the <br />Declarations as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to indUde as an imiured the person or <br />organization shown in the Schedule, but only with respect to liability arising out of "your work" fOf <br />that insured by or for ~OU. <br /> <br />PRIMARY WORDING <br />It is further agreed that such insurance as is afforded by this policy for the benefit of the additional <br />insureds shown above shan be Drimarv insurance, but only 85 respects to any claims, loss or <br />liability arising out of the named insureds operations. and any insurance maintained by the <br />additional insureds shall be non..contribumg. <br /> <br />Should any of the polic/fIS be cancelled before the expiration date thereof, the issuing <br />company will mall 11]0 days writt&n not#ee to the cerliflclIle holde,. ..,0 days notice to, <br />non-payment does apply. <br /> <br />CG 20 10 11 85 Copyrigh~ Insurance Services Office, Inc. 1984 <br /> <br />A,PPROVED AS TO FORM <br /> <br />J438 ]>13 <br /> <br />- ilLaura Stitt Sheedy <br />,~"istant City Attorney <br /> <br />p.4 <br /> <br />P.04/04 <br /> <br />TnHll P D1.d <br /> <br />