Laserfiche WebLink
<br />Additional Insured - Owners, Lessees or Contractors - AB 90 67 12 93 <br />Policy Amendment Section II <br /> <br />Insured <br /> <br />Community Veterinary Hospital Inc. <br /> <br />Policy Number <br /> <br />AZC80767283 <br /> <br />Producer <br /> <br />ABD Insurance & Financial Services <br /> <br />Effective Date <br /> <br />10101/04 <br /> <br />Schedule <br /> <br />Name of Person(s) or Organization(s) <br /> <br />City of Santa Ana <br />20 Civic Center Plaza, M-30 <br />Santa Ana CA 92702 <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.) <br /> <br />The following is added to Part I. - WHO IS AN IN- <br />SURED in the Business Liability Section of the policy: <br /> <br />5. The person or organization shown in the Schedule <br />is also an insured, but only with respect to liability <br /> <br />arising out of your work for that insured by or <br />for you. <br /> <br />All other terms and conditions of the policy apply. <br /> <br />This Form must be attached to Change Endorsement when issued after the policy is written. <br />One of the Fireman's Fund Insurance Companies as named in the policy <br /> <br />Secretary <br /> <br />President <br /> <br />'1 U Li) i\:" fO l'O~~ :',; <br /> <br />~::,:~:, ~~::'igh"d M,t,,,,] 0"",""",, Smi", om". I",. 1984c*-~;~7_ .. <br /> <br />(\\Ad.Sac-fsIL;serarea\Njc\My Document:;\Asoociallon Cen FormslAI AS 9067 Doc) <br /> <br />