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<br />tte: 10/13/2004 Time: 1:37 PM To: JOQ Farco @ 17146475635 <br /> <br />1,510,452,2193 <br /> <br />PaqQ: 003-003 <br /> <br />I <br />.. <br /> <br />" <br /> <br />POLICY NUMBER: GEC000340604 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - DESIGNATED PERSON or <br />ORGANIZATION <br /> <br />I, I <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />IIi <br />ij; <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />II; <br /> <br />SCHEDULE <br /> <br />ji i <br /> <br />Name of Person' or Organization: <br /> <br />City of Santa Ana <br />Public Works Agency <br />Attn: Joe Parco <br />Civic Center Plaza M-36 <br />Santa Ana, CA 92701 <br /> <br />I <br /> <br /> <br />, <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) ,I I <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in <br />the Schedule, but only with respect to liability arising out of your operations or premises owned by or <br />rented to you. <br />ENERAL LIABILITY ADDITIONAL INSURED: The City of Santa Ana, its <br />!ficers, employees, agents, volunteers and representatives are <br />dditional insureds to general liability. <br />, . <br />'I Ii: <br />PRIMARY INSURANCE: <br />IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY <br />AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED <br />SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS <br />INSURANCE. <br /> <br />SEVERABILITY OF INTEREST: <br />IT IS AGREED THAT EXCEPT WITH RESPECT TO THE LIMIT OF INSURANCE, THIS <br />COVERAGE SHALL APPLY AS IF EACH ADDITIONAL INSURED WERE THE ONLY INSURED <br />AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAIM IS MADE OR SUIT IS <br />BROUGHT. <br /> <br />APPROVED AS TO FORM <br /> <br />~ <br />if <br />I, <br /> <br />~~,{~ <br />V uta Stitt Seedy <br />NlistaDt City Attorney <br /> <br />I <br />, , I <br />, <br />r-~ I")n "X:l -t-t oz:: <br /> <br />i'i I <br />