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<br />UQI/J/2UUD Ur:ZH ~AA <br /> <br />14JOO~/OO!j <br /> <br />Additional Insured - Owners, Lessees or Contractors - AD 90 67 12 93 <br />Policy Amendment Section II <br /> <br />Insured <br /> <br />Community \'eterlnary Hospital, Inc. <br /> <br />Policy Number <br /> <br />AZC80790199 <br /> <br />Producer <br /> <br />ABO Insurance & Financial Services <br /> <br />Effective Date <br /> <br />10101105 <br /> <br />Schedule <br /> <br />Name ot' Person(s) or Organization(s} <br />City at Sa"'" Ana <br />20 CivIc Center Plaza, M.30 <br />Santa Ana CA 92702 <br /> <br />(If no entry appears abQv~, infonnation required to complete this :Endorsement will be shown in the Declarations <br />as applicable to this Endorsement.) <br /> <br />The following is added 10 Part I. - WHO IS AN IN- <br />SCRED in the Business LJability Sectinn of the policy: <br /> <br />arising out of your work tor that insured by or <br />for you. <br /> <br />, <br /> <br />The person or orgalJ ~zation shown in the Schedule <br />IS also an insured. hut only with respect to liability <br /> <br />All other tenns and conditions of the policy apply <br /> <br />This Fi)rIl'i must be attached to Change Endorsement when issued afh.."! the policy is ",rit1eI1. <br />Om:: of the Hreman'~ Fund InsunlDce Compaule~ as nar;led in the policy <br /> <br />Secretary <br /> <br />President <br /> <br />AB:J06"'12-'H <br />Conta;nscop)Tighted Mat.eri[jJ of ln$lcl'<lll<::e Services Ofllee. ,"'c,> 1984 <br /> <br />("^c1-Sac..rs"Ulel'Wdo'<NjclMy D<.>~~mcnl\\ '""'-""....iOll Com F<'>IlIl>\i\/ AD ~7.Docl <br /> <br />. / rJ/C <br />-~-~7 <br /> <br />