Laserfiche WebLink
MAY-013 -2004 09:24 THE CAMBODIAN FAMILY 714 571 1974 P.04 <br />ADDITIONAL .INSURED ENDORSEMENT <br />InsuranCA Company PHILADELPHIA INDEMNITY INSURANCE CO. <br />T is ndor 6 5 rot es such <br />e tInsurance as Is afforded by the provisions Of Policy <br />H <br />1. The City Of Santa Ma, 20 CM0 Center Plaza, Santa Ana Callfomia 92701; <br />b officers, employees, agents and representatives airs named as additional insureds <br />Cadditional insuredsl with regard to flablilyy and defense of suits arlsing from the <br />operations and t.tses performed by or an behalf of the named hstired. <br />2. With respect to claims arising out of the aperattons and uses performed by <br />or on behalf of the named kstrred. such insuranoe as i5 afrorded by this parley is primary <br />and is not additional to or contributing with any other insurance carried by or for Vie <br />benefit of the additional irwAvds- <br />3. . •this rwxgumm apptles separately to eaph Insured against whom claim is, <br />made or suit Is brought weept with rasped to the oampany's fiffft of 12bUity. The <br />Inclusion of any parson or orgatttzadon as an insured shall not allied any right which such <br />person or orgwindon would tam as a Balm m if not so kneaded. • <br />4. Watt respect to fhe addMonal insureds, this iris xw" sChalt not be cenW ed, <br />or materWy reduced In covemm or limb except Mier thirty N days wribn notice has <br />been given to the city of Santa Arta. 20 CMa Center Plea, Septa AM.Callomia 82701. <br />(Completion of the folkrMng, including counter$Ignat6te, is required to make this <br />endorsement -eftectivo ) <br />Ef ,Mve 03 / 09/ 04 this endorsement form as a part of <br />r <br />Policy # PHPKQZ4625 <br />Issued to • THE CAMBODIAN FAMILY <br />Named Insured <br />Countersigned by - <br />EXHIMIT 0 . <br />TOTAL P.04 <br />