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<br />1..., ~'''''I~uutJ 'J.'lmel 4109 PM TOI Chiz-:i, Mario Ii 171464754:U <br /> <br />. <br /> <br />1.510.452.2193 <br /> <br />Pa<:el 003 003 <br /> <br />, <br /> <br />Policy Number: BK0189589:, <br /> <br />OwnersbLessees or Contractors (Form B) <br />ADDITI NAL INSURED <br /> <br />Change(s) Effective: 03/27/1'6 <br /> <br />THIS ENDORSEMENT CliAN'3ES THE POLICY. PLEASE REAl) IT <br />CAREFULLY. This endorneml;nt modifies insurance policy under Ihe following: <br /> <br />LIABILITY COVERAGE PART: <br /> <br />Name of Person or Orgal1lzalion: <br /> <br />City of Santa Ana <br />Building MaintenancE! D:_ vision <br />Attn: Mr. Mario Ghizzi <br />20 Civic Center Plaza, ~-11 <br />PO Box 1988 <br />Santa Ana, CA 9270:;! <br /> <br />Schedule <br /> <br />SECTION" - WHO IS AN INSURED is amended to include as an il1sured the <br />person or organization shown 'r! the Schedule, but only with respect to liability <br />arising out of "your work" for thet insured by or for you. <br /> <br />City of Santa Ana, its officers, agents, volunteers and <br />representatives are nar~ed as an additional insured as respects gener,,] <br />liability for claims aJc:lsing from the operations of the named insurec.. <br /> <br />PRIMARY INSURANCE: <br />IT IS UNDERSTOOD AND Am~EED THAT THIS INSURANCE 11:, PRIMARY <br />AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIOl'iAL INSURED <br />SHALL BE EXCESS ONLY AUD NOT CONTRIBUTING WITH THIS <br />INSURANCE. <br /> <br />SEVERABILITY OF INTEJ:<.Et;T: <br />IT IS AGREED THAT EXCEPT WITH RESPECT TO THE LIMIT OF INSURANCE, THH; <br />COVERAGE SHALL APPLY A1l IF EACH ADDITIONAL INSURf;D WERE THE ONLY INSUR;:D <br />AND SEPARATELY TO EACH INSURED AGAINST WHOM CLAn! IS MADE OR SUIT IS <br />BROUGHT. <br /> <br />WAIVER OF SUBROGATION: <br />IT IS UNDERSTOOD AND AGRSED THAT THE COMPANY WAIVE,3 THE RIGHT OF <br />SUBROGATION AGAINST THE l\BOVE ADDITIONAL INSURED '.S I, BUT ONLY AS RESPECTS <br />THE JOB OR PREMISES DEt;C:<.IBED IN THE CERTIFICATE ATTACHED HERETO. <br /> <br />CUBF 22 40 03 95 <br /> <br />~ ;</z_ <br />_._". /0(/ <br /> <br />