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STAMEN, TED 1 - 2004
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STAMEN, TED 1 - 2004
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Last modified
3/26/2024 2:35:37 PM
Creation date
1/25/2005 12:01:34 PM
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Contracts
Company Name
Stamen, Ted
Contract #
N-2004-135
Agency
Parks, Recreation, & Community Services
Insurance Exp Date
4/10/2005
Destruction Year
2010
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EXHIBIT B <br />ADDITIONAL INSURED ENDORSEMENT <br />FOR COMMERCIAL GENERAL LIABILITY POLICY <br />Insurance Company <br />This endorsement modifies such insurance as is afforded by the provisions of Policy <br /># relating to the following: <br />1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its <br />officers, employee- <br />vnhmteerc and re.nre.se.ntative.a are. named as additional insureds <br />("additional insure <br />L X\ i '� <br />in the operations <br />and uses performe. <br />2. Wi1� <br />)erformed by or on <br />behalf of the name <br />additional to or co <br />S S� 5 ��� 12� <br />rimary and is not <br />:nefit of the <br />additional insured: <br />3. Thi <br />} n q4,3 < M e) e\ 40 <br />)m claim is made or <br />suit is brought exe <br />; inclusion of any <br />person or organiza <br />rson or organization <br />would have as a cl <br />4. Wil <br />tot be cancelled, or <br />materially reduced _a_ __ _____ i notice has been <br />given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. <br />(Completion of the following, including countersignature, is required to make this endorsement <br />effective.) <br />Effective <br />Policy # <br />Issued to <br />this endorsement form as a part of <br />Named Insured <br />Countersigned by <br />Authorized Representative <br />
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