Laserfiche WebLink
<br />08/04/2004 WED 09:06 FAX 714+565 4020 CITY OF SANTA ANA <br /> <br />14J00J/005 <br /> <br />~ul IS 04 09~00a <br /> <br />T 111!!1C 1 <br /> <br />p-3 <br /> <br />THIS SHEET MUST BE COMPLETED AND ACCOMPANY <br />THE CERrIFlCATE OF INSURANCE <br /> <br />" <br /> <br />ADDITIONAL INSURED ENDORSEMENT <br /> <br />Insurance company STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY <br /> <br />This 8ndor5ement modifies &UGh insurance as is afforded by the Jrovisions of <br />Policy No.F20-0741-A01-'75C relating to the following: <br /> <br />1. <br /> <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, Califomia 92701 its <br />office r5 , employees, agents, and representatives are named as additional <br />insureds ("'additional insuredsj with rsgard to liability and defense of suitS arising <br />from the operations and uses performed by or on behalf of1l1e named insured. <br /> <br />2. <br /> <br />With respect to claims arising out 01 the operations and uses performed by or on <br />behalf of the named insured, such ìnsuranee as is afforded by this policy is <br />primary and is not additional to or contributing with any other insurance carried <br />by or for the benefit of the additional insureds. <br /> <br />3. <br /> <br />This insurance øpplies separately to each insured against whom claim is made or <br />suit is brought except with respect to the company's limits of liability. The <br />inclusion of any person or organization as an insured shall not affect any right <br />which such person or organization would have as a claimant if not so i~cluded.. <br /> <br />Wirh respect to the additional insureds, this Insurançe shall not be cancelled Dr . <br />materially reduced in coverage or limits except after thirty (30) days written notice <br />has been given to the City of Santa Ans. 20 Civic Center Plaza. Santa Ana, <br />Caljfomia 92701.' . <br /> <br />4. <br /> <br />~ <br /> <br />(COmpletion of the folloWing, including countersignature, is required to make this <br />endorsement effective.) <br /> <br />Effective <br /> <br />JULY 1, 2004 <br /> <br />I this endorsemenl form is a part of <br /> <br />Policy No. J20-07 41 -A01-75C <br /> <br />Issued to J~ES H RUSELL & SON INC ~--,~_.__.- --- <br />Named Insured <br /> <br />':' <br /> <br />KEL~ ~~~ <br /> <br />Countersigned by <br /> <br />H:misc;Ct<lÌfiØtI; of ID'1lfõ\II1: addXlœ~1 mdanl:l1Iml <br />