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Mar 17 OS 03:31p Boys & Girls Club Of Sant 714 -565 -1099 <br />Mar 17 05 02:46(+ Boys a Girls Club 0i Sant 714 -565 -1099 <br />ri 1 -sveo �s..�+n rw yvv,.. nab, -AW 1v .,< o reaw <br />1EXHtWT ti <br />' a ; ae .• <br />flputamee C°mMmy_ wwG /ti S <br />This eedomement modifies mcb iaearaege as is afibrdod by the provisions of Policy <br />tP �6oyQ2I .R.t)3- oStelalinfimtpofolloai� <br />1. The City OfSS tNaen a.20 di* Center Plw,SAULAA%C.Efomia <br />92701; ks offieam employees, noses, volunta is and r uesem olives are named as <br />additional ianrelr ("additional issuiW) with re&W to liability aadekfmtse Of BUM <br />arising from Una operwom std Wu ppfaaned by or oa behalfof the mooed h umvea. <br />2. With respect to chime tuising oat of rho opastiaw sod us" ptafonoed by <br />or on boWfoftbm tamed insmal, such insutaaea as is afforded by this policy is prirairy <br />and is nos additional to at coial ibuting with say odue itsumnce cAviod by or for the <br />benefit of the sddWottal it si cads, <br />3. Thus ittsv v=apphos sepatatdy to sack im ned a AmK wtn&n claim is <br />made of sditis broa* exceptwid& A to the a0mpamys hiodts of liability. The <br />inuJusion of >oypensan or orgabiadina as ten dttaured "I not affect any rifbt which such <br />Person Or msgim-tian would have a a claimtan if not m Waded. <br />4. Wilt rmWct 10 the additional insureds, Oda *aW*no *Wl net be <br />camaelled, or masuialiy rmduced in covmrage at limits "t afterddtty (30) days written <br />Wise has hose give& ten the City of Satda Ana, 20 Civic CadtRPlex&, Sara Ana, <br />Calilbmia 92701. <br />(Completion Of Ibis following, including cousi 4aabnt, is r"Wrad to take this <br />endoreetnat et4eriva.) <br />Etfactivo '-4,104e X .r d3 , this andarsenxad form a a pat of <br />pohcyp t6a'L'0���'.:.4� <br />Issued to L4, vs .. r.^.: -/1 e--1 -4 •_f _X --'4rr <br />Cotatlpsigned by <br />APPROVED AS TO FORM <br />�LLc;a Stitt Sheedy "-- <br />Assistant City Attornev <br />p.2 <br />p.2 <br />zelze -.xd 321aros113343H <br />6059- SiZ -fib6 E0;9t 500E /LtlEO <br />