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CAMBODIAN FAMILY, THE 4
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CAMBODIAN FAMILY, THE 4
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Last modified
10/15/2015 12:31:58 PM
Creation date
11/20/2004 3:56:09 PM
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Contracts
Company Name
The Cambodian Family
Contract #
A-2004-087-09
Agency
Community Development
Council Approval Date
5/3/2004
Expiration Date
6/30/2005
Insurance Exp Date
3/9/2006
Destruction Year
2010
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APR -29 -2005 11007 THE COmDODIAN FAMILY 714 `71 1974 P.04. <br />%F14 <br />ADDITIONAL. INSURM ENDORSEMENT <br />tnsurancm c«ttparty EHII.ADUPHIA a LIJ1111Y INKRANCE 00. <br />ihlt WXWMeMeM ntodfies such kmwwm as In W70d. od by tha provhfom of Poigr <br />Pax„ or;4 a __ rala" 10 the tboovrir <br />t. The c*y of &tents Ana, 20 CMo Canty PWM -%ft Ana, Catiornta 82701; <br />its docers, arpto "% and rapraeertfa>k an named es eddidone[ hounds rqaxdodMoWom W labft � �l or on bWW owl fm named wed. IFom the <br />2 Wlh respect to CWnte W%ft out cf *w op - -o ll- r and uses portbm,ad by <br />cr an tiahaif cants named kmo*4 a xh k+ xmvs as is sltorded by atb policy b primary <br />and iS not iddtb'ono fo or eontrbArlg vah any outer htura me a rind by or for the <br />bona t of the addMorl-d h ure t. <br />3. Thts amurwtce apples aapweteiy to esctt kwmvd agdnat whom deim e <br />nude or suit la brouatt altoept with reaped 10 ft Company's WOO of 19ft, lire <br />ktckwm dart' parson or ofgeretadon so an kwjmd am not aft* wt' right %fkh such <br />parson or a no I edocf would hens as a datrnent d not so ktaluded <br />4. Wdhr/opecttofteddidmtol lhkiMtsanl *Wnabefo oiled, <br />or metertaly t etluCed ti cuverspe or knb a wo$ after fNkly $q dop wdbn ndk a has <br />peat given to the Qty of amts Ant; Zn avfo Cantor P Sent kA.080m rra eV01, <br />(CompWgon of Vie foUaMng, Wuding couttteraignpuital is required to make 0* <br />ondwoornent effwft&) <br />Eftecove 03/09/2005 , this enckwv ment form as a part of <br />poppy # _ PflrKI.10443 <br />fosudd to '1& CAMBODIAN FAMELY <br />Named Ittaured <br />Countersignedby ��n!M- ±� °f1""�_ 3, 1•� <br />APPROVED AS TO Fo k vi <br />3,3 <br />EXHJRIT D Laura Stitt Sheerly <br />Assistant City Attnrnw <br />TOTAL P.04 <br />
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