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<br />Va,';., 1/2,/200< T1me, 0,0. AM To, <br /> <br />8 1114<475<21 <br /> <br />1-510-45.-0193 <br /> <br />"oe. 003-003 <br /> <br />Policy Number: BKO1473871 <br /> <br />OwnersÒLessees or Contractors (Form B) <br />ADDITI NAL INSURED <br /> <br />Change(s) Effective: 01121/04 <br /> <br />THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT <br />CAREFULLY, This endorsement modifies insurance policy under the following: <br /> <br />LIABILITY COVERAGE PART: <br /> <br />Schedule <br /> <br />Name of Person or Organization: <br /> <br />city of santa Ana <br />Mario Ghizzi;Building Maintenance Division <br />20 Civic Center Plaza, M-l1 <br />Santa Ana, CA 92702 <br /> <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 /> <br />City of Santa Ana, its officere, agents, volunteers and <br />representatives are named as an additional insured as respects general <br />liability for claims arising from the operations of the named insured. <br /> <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 THIS <br />INSURANCE, <br /> <br />SEVERABILITY OF INTEREST: <br />IT IS AGREED THAT EXCEPT WITH 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 IS <br />BROUGHT. <br /> <br />WAIVER OF SUBROGATION; <br />IT IS UNDERSTOOD AND AGREED THAT THE COMPANY WAIVES THE RIGHT OF <br />SUBROGATION AGAINST THE ABOVE ADDITIONAL INSURED(S) , BUT ONLY AS RESPECTS <br />THE JOB OR PREMISES DESCRIBED IN THE CERTIFICATE ATTACHED HERETO. <br /> <br />Cl/BF 22 40 03 95 <br /> <br />~ ;2/~ <br />