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<br />. FILE No.S9O 02/11 '04 15:56 <br /> <br />lD:W.BRUWN & ASSOC. <br /> <br />FAX:949 4.-~ 1398 <br /> <br />p :Œ <br /> <br />3/ 3 <br /> <br />" ......... <br /> <br />~ <br /> <br />~ <br /> <br />.. <br /> <br />PRIMARY INSURANCE FOR SPECIFIED ADDITIONAL INSURED <br />ENDORSEMENT <br /> <br />THIS ENDORseMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />This endor&ement modifies insurance provl.jed under the following: <br />COMMERCIAL GENERAL IJABILn Y COVERAGE FORM <br /> <br />Thl& endor8ement changes Ih8 poficy effee1ive on the Inc8ption date of the policy unIe88 another date is indicaterj <br />below; <br /> <br />(The following needs to be completed only './hen this endorsement is issued subsequent to inception of the pollc!'.) <br /> <br />Named lnaured <br />TDlerico'. El8c8ric <br /> <br />, <br /> <br />Endorsement Effective <br />2+04 <br /> <br />Polley Number <br />CLP8251323 <br /> <br /> <br /> <br />I~by I <br />c9-L ~.~ i <br /> <br />(Authori2ed Repre.e.ntative) <br /> <br />With regard to ooverage provided by this en.totsement only. SECTIOH IV - COMMERCIAL GENERAL LlAIlLn y <br />CONDITIONS. 4. Other Insurance, p8I'8gI':1ph .. Primary IMUf1Ince is modifl8d as follows: <br /> <br />a. Prlm.ry In8Uranc8 <br /> <br />The Insurance afforded to the A1ditionallnaured <br /> <br />City of Santa Ana <br />1000 E. Sa..... Ana BlVd. iI108 <br />Santa Ana. CA 92101 <br />Is primery ftndnon-contfibutory \ vitti respect to liability ari8ing out of work performed by the Named <br />Insured. <br /> <br />~ReL'j ~ <br /> <br />I <br /> <br />All otner terms and oonditiona of this policy re main unchanged. <br /> <br />nn...r-L ~SH;7 (~-ð~) <br />