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CAMBODIAN FAMILY, THE 3 - 2004
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CAMBODIAN FAMILY, THE 3 - 2004
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Last modified
1/3/2012 3:07:47 PM
Creation date
11/20/2004 3:40:29 PM
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Contracts
Company Name
The Cambodian Family
Contract #
A-2004-167
Agency
Community Development
Council Approval Date
8/2/2004
Expiration Date
6/30/2005
Insurance Exp Date
3/9/2006
Destruction Year
2010
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<br />. MAYJJ.3-2004 09: 24 <br /> <br />THE CAMBODIAN FAMILY <br /> <br />714 571 1974 <br /> <br />P.04 <br /> <br />. . <br /> <br />. . <br /> <br />. <br />ADDITIONAL .INSURED ENDORSEMENT <br /> <br />Insurance Company PHILADELPHIA INDE1-;NITY INSURANCE CO. <br /> <br />This endOl'Seqleot mOdIfies such Insur8n06 as Is affor~ad by the provisions of Policy <br /># PHPK074bZ5 I'8laUng to the folloWing: <br /> <br />1. 'The Clly OIl Santa Ana, 20 Civic c.nter Plaza, Santa Arta. California 92701; <br />ItS oIfIcers. employees. 8g1!ln13 end representatiws Bre named as addltlonel insureds <br />("add'Jtional InSIJreds") with regard to Rablily and defense of suItS arising from the <br /><meretlons and IJS@S performecI bv or on behalf 01 the named InsUred. <br /> <br />.'. , <br />2. Wdh respect to dllirns 9tItIng out Of the operatlQnIS and uses per1Ol'l1led by <br />or on behalf of \he named InSUred. suotllnsuranca as is afforded by lJ'IiS policy is primary <br />and i$ not addIiloMI to or contributing with Iny ClIher insurance carried by 01" for the <br />bendt of the addtionBl insUreds- <br /> <br />3. ,"TNa II'l5UI1tllt;tI appUes separately to ~ Insured against whom daim is <br />made or suit Is brought except with respect to the ccmpany's Omits or labll1ly. The <br />lnofusion of 3l1'/ person or cxglWllz8don as an insur-d $haI1 not affect any right which such <br />person or organI2aIIon woUd haVe as a dalmem if nOl so 1neIuded. <br /> <br />4. WIth~ to1M eddiIIanBIlnsureds.lhis insurance shall not be canoeIIed. <br />or materially rIductcI In coverage QI" imil:l exc:eQt etter IhIrty (3D) d8ys written notice has <br />been given to the Cly 01 Santa Me. 20 CMQ Center Pl8Z9, Santa Ana, ,Callf0mi8 92701. <br /> <br />(Comp\.QUon of the following, including counterslgn;atUre, is required to make thIs <br />endorsement .etreotiVe.) <br /> <br />. Erf~vlll 03/09/04 <br />. <br /> <br />I this endorsement form as B part of <br /> <br />Policy # PHPK074625 <br /> <br />Issued to . THE CAMBODIAN FAMILY <br />Named Insured <br /> <br />Caunters.lgned by <br /> <br />~vo~ <br /> <br />.\f'FH)\:: ' <br /> <br />-.--YtP 3/3.. . <br /> <br />UIlIAtT 0 <br /> <br />TOTAL P.04 <br />
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