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ARDENT ERGONOMICS (MELGOZA, JORGE)
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ARDENT ERGONOMICS (MELGOZA, JORGE)
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Last modified
6/15/2026 2:20:21 PM
Creation date
3/7/2025 10:01:50 AM
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Contracts
Company Name
ARDENT ERGONOMICS (MELGOZA, JORGE)
Contract #
N-2025-049
Agency
Human Resources
Expiration Date
2/18/2027
Insurance Exp Date
10/15/2026
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CM P-4787 <br />Page 1 of 1 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE <br />Policy Number:90-AP-K491-7 <br />Named Insured: <br />MELGOZA, JORGE B <br />Name And Address Of Person Or Organization: <br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers <br />20 Civic Center Plz <br />Santa Ana CA 92701-4058 <br />The following is added to Paragraph 10.b. of SECTION I AND SECTION II — COMMON POLICY CONDITIONS: <br />We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we <br />make for injury or damage arising out of: <br />a. Your ongoing operations; or <br />b. "Your work" done under contract with that person or organization and included in the "products -completed operations <br />hazard". <br />This waiver applies only to the person or organization shown in the Schedule. <br />All other policy provisions apply. <br />CMP-4787 1008498 2001 151229 201 05-14-2019 <br />©, Copyright, State Farm Mutual Automobile Insurance Company, 2008 <br />Includes copyrighted material of Insurance Services Office, Inc., with its permission. <br />
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