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. . ~ - ------.---..-.-- -- ____n______n.u- ~--- ---- - ---- - - ---- ---------.--------..---. ADDITIONAL INSURED ENDORSEMENT- NON AFFILIATED ENTITY - --------------------, ----------- ------- ------------------- ~ ~-~~---------~~'--'~--rËñdori;ment Number ----1' -~-- ..H' -- -- ---_! I;.' Effective Date of Endorsement ¡ , i I 4/2~/2!1QL_____! 12/1/04 ' ; . . ----------=-~.:-::-~--~-=-=====:::........-.-- -----_==-=::,::,,:=--"-j I ! --"---------------'--------- ., r IINamea-¡ñiurecr ----m__~~-_~~._--~--_.._~,,_. , Card Metered Systems, Inc. .-.....- --- - --- ! Policy Number Policy Period i~~RL_l~9~0. - _.__._._=c:==_~2!!/2004_=--=~=-c-= i Issued By (Name of Insurance Company) L____~~~_~~eri~~_!~~~~~,=--~~~~~~X._- -- -..-------------------,-.--- ~_...._--_._-- " -----------..----- ,. .--"---- - ---------- -_._._..__.._--~ ~._----------- -- ----------_--'._0',"0...___----- Insert the policy number. The remainder ot the information is to be compteted only when this endorsement is issued subsequent to the preparation of tl1e policy. ------ ---------------. - -------------- ------- - ______n______------ -- "--.---------"--.---------- The following Special Conditions apply to your policy: SECTION 1- DEFINITIONS, has been arnended to include the following: r r Additional Insured means any person or organization: r (1) which is not owned or controlled by any insured; and (2) which does not own or control any insured; and (3) which is not affiliated with any insured through common ownership or control; and (4) in which no director, officer, partner nor principal stockholder is an insured otherwise covered under this policy - ¡ ; i , i as scheduled herein. The coverage afforded to the additional insured applies solely to liability arising out of wrongful act(s) , of insured(s) in their perfonnance of or failure to perfonn professional services on behalf of the Named : Insured. i SCHEDULE OF ADDITIONAL INSUREDS : City of Santa Ana 20 Civic Center Plaza Santa Ana. CA 92702 ~ ¿ /z. Nothing contained herein shall be construed as increasing the limits of liability available to pay any claims(s). , All other terms and conditions of this policy remain unchanged. This end rsement is a part of your Policy and takes effect on the effective date of your policy, unless an er elle iv~date is indicated on this endorsement. PF 8X31c (10/99) _____n--_--__-