Laserfiche WebLink
<br />l1ar 17 05 03:31p <br />, <br /> <br />Bo~s L Girls Club or Sant 714-585-1099 <br /> <br />p.2 <br /> <br />M.r 17_?~~~~,~f___ go~s ~ Girlc Club 09 S~nt 714-565-1099 <br />- ... ---.-. ,......". ~"lI.... '*'- ....cw 1"" ~'4 o.:ao ,~ <br /> <br />~~~ <br /> <br />EX8J1lI'l . <br /> <br />ADDrrIDNAL INSlJRliD t:NnnII"~:"""1!NT <br />'fOR. NlUMl'.RMAl OllNl!llAL U"JlllITVPOLICY <br /> <br />~Compoll)' <br /> <br />k4'{/~k",~..s; <br /> <br />This tIlMIcm;cmenI modifies Neb inounnoc u ia alfonled by 1M proviaiOM of Polioy <br />, 6'6PVD7.f.~",7J...t"Id"co 1Il,(01lo..a.s: <br /> <br />I. TIlcCilyofSQmAII.. ZOCi>ic Ceaf8rP_ S-An.. C.Jifi>m;. <br />92101; III olll..... CIIlPIo_. qaiu. vollll1_' IIld repr<SeDtadves "'" 1lII1I." as <br />...........01-.... (""'iticmol iMbmds") will> repnllO Uabilioy _ deI'_ or...;.. <br />arising &vm 1M opcrlIIiens lIIId _ porl>.OWd by or on b_ oft"" .......d iltstRd. <br /> <br />2. Willt fCSPOICl to claims uilri"l 0111 of.... ..,..aciGoIa_ .-llldOmlIlI by <br />or Oft bdlaIt of1M Nmlld iDslDed. ndI m..nnc. II is alfoItIod by .... polk;y ill primary <br />Mil is DOtadclillaDal toGl'ClIIIIributmawitb 1D)'0t!ler insurw:ew.rioclbyorfor.... <br />belwlll of llIe addl1ionaI inaindc. <br /> <br />3. This dtBlll'ltlCC"I'PliII seplPtely 10 BICh in5urecl rpa.t whom claim is <br />m. or .wI is b<tIllJIII..copt widI IIIJl'ICI III IIlc ..........y'.liIDito ofliability. Tho <br />j11clu8loG of mypouon or orpeIutioD II III _roc! sIIIIllIOl afIWct my II.,. which SIIOh <br />person or.....2Iliaft _ld. ba'ltllll' elaimllllt if IIOt so iDcIudc4. <br /> <br />4. Willi ""IItet to the aWitiollll ;,.",.. rhIlI iIlsln_lIflall 001 be <br />..""dIed, or -iaJIlr rocIucocl ill......... ot limlts.....,,1 aft...1hiny (30) days wti_ <br />IIIlticc has b-. pv... 10 lhc Cil)' ofSanla ADa. :lO Civic CCIIlCI' Plaa, S_ AlIa. <br />Calilbmia 92701, <br /> <br />(Cootplelion oCm. 1i>IIowma. lDtladin& _..-.. ia roquirod to JIIair.e 111). <br />~_..ent etl;ctivc.) <br /> <br />Efibolivo <br />Pulley. <br />Issued to <br /> <br />~./g,,~/Y ~ ~$- ,Ihi.-.-lbrmtuponof <br />.lfiSItJ'741A.:i7.:J -d~ <br />~y's * d'...',-/..r c/_~ Ir ("'....A; ~~ <br />, , NllIJocI'IIlSlItcd <br /> <br />Co......>ipW.,. ~~~ <br /> <br />APPROVED AS TO FORM <br />., <br /> <br />~~)2/c <br /> <br />.aura Stitt Sheedy <br />ASSIstant City Att <br />orney <br /> <br />eluelil 39t'd <br /> <br />30.!0JS.u .B'al: <br /> <br />613SS-Stz-61>6 <br /> <br />E13:gr S1313eILr/E13 <br />