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<br />. . <br /> <br />05/06/2005 15:12 <br /> <br />7145714209 <br /> <br />PARKS AND RECREATION <br /> <br />PAGE 04 <br /> <br />FROM , = CRAL.l'TI<D STl'lTE Fl'lRM INS F"'X NO. <br /> <br />714534112106 <br /> <br />M.r. \'l2 2005 1:13: 29PM P4 <br /> <br />511 Policy No. 92 -QN"7569-l <br /> <br />,-:--;.,l..'. <br />.~-~~ <br />.' ~~ <br /> <br />ADDITIONAL INSUREb ENDORSEMENT <br />DESIGN'" TED PR~MISe:S ONLY <br /> <br />fAl <br />~ <br /> <br />POlicy No.: ., 'QN-7569-2 <br /> <br />Named Insum, <br /> <br />SiNS!, ERIC M Ill! <br /> <br />,"",e 01 AdclilioIHlllneunld: TIlE CITY OF GlINT" l\N)l. <br /> <br />Adelf." Itf Additionlllntuted: ~o CIVIC <:1ll'lTER PLZ <br />SANTA ANA CA 92701-4058 <br /> <br />lnlll'..l of AddlliOnalln'l.Ir.', USt;lQR <br />(SPECIAL EV~T ON PEB. 22, 200~, MARCH 29 2005, <br />APRIL 26 200. AND MAY 31 2005 ONLY) . <br /> <br />L......tion of Pnln.lsu: SANTIAQO LAWN BONLING C1.1JiIHOVSJ;l <br />S1.0 M!:MORY LN <br />SANTA AN~ CA ,9~706-1~25 <br /> <br />Tho> wDI'd "InSUIlIO', wher...r uslKl in thiS policy, \lleo includes the designated person or "'ganlzallon namecl2l>oVli! <br />as Addilit;ln\lII~Sll'ed under !,he provilions Of the policy aeelion. .hown belloW liS appllCl!lble by an "X" to the ex:en: <br />jndicated. <br /> <br />o SECTION l. <br />o SECTION I, <br /> <br />This IIpplie. only to COVERAGE A . BUILDINGS. <br />This applies Qnly to COVERAGE B - BUSlNU8 PERSONAL PROPERTY. <br /> <br />DQJ:Cri~,ti"n of Property: <br /> <br />00 SECT10N II. TIllo appru.. only to COVERAOI L - BUlllNEU LIABIUTY and COVERAGE M - <br />MEDICAl JOAYMENTS IIIld then only wtth "'.PoetlO th" owne,ship, maintenance "'" "" of <br />_he premiSM des.lgnatM above end epsr9tionl;;. n8C8sssry Of incidGntsl Ulereto, ihQQQ <br />SeCTIOlI/1l ~v..rll9"'. do n(>t apply 10: <br /> <br />1. .lructu'al ..Iteration. or new construction performed by or on behalf of the designeted peroon or <br />organi.z:Jtion; <br /> <br />2. jMtllOnlil iilllity cau.ed by the ileaigna\ed per.on or orllanlz"flon; <br /> <br />3. tlabilily 11\41 d...igna\e<l p....on or orgQnlZll~On assumed Iinller a Don tract; or <br /> <br />4, prelluets-e"",p.elttd oper.~Ort, hazard "rilirlg 01.1' of good& 0' fnv<<1tory whi6t\ ar~ ,..ot solcl or <br />ClISlrillut..d by you o. arising out of \he mahufacluring o. packaging of ouch !loods Of invenlory. <br /> <br />All othlltr provision51 ot th8 policy aDPly. <br /> <br />l'Eo/ililll <br />~711l1) <br /> <br />APPROVED AS TO rv-". <br /> <br />~,;;<S ?:> / :? ".""',, "-,"- <br /> <br />Laura Still Sheedy <br />AssIstanl City AllQI'I'I~\' <br />