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Hue 15 05 11:15a Boys L Girls Club Of Sant 714 -565 -1099 17.9 <br />Hue ho ua hutaaa r" <br />AD0rr10NA1 MMF1) FTMR—.SP.MtFNT <br />t'UR LOMhat3tclAL CfiNERAL_1 UIBF ITY t <br />'this codow3mac l modifies uxb wasance as is afforded by the pror'tsiotts of Policy <br />0 wo4o7912ia. -o9 �lafia�kochCfollowing <br />1. 'The Ciy of gamier Ana. 20 Civic Ceata Mai, i, Strata Att; California 92701; its <br />otfihaxs, taapioyme. agma_ v..lumecm and ropola gaUvesixt wood as addiuorN i %UUC& <br />(,"tdditloual itrtreda7 wilt aegard to SaWrAy and dcfwm of wits angler( from the oparadood <br />and n rs Wmnedby or on behalf of the named inswed. <br />3 with nsp to claims airing oat of tba operations ani hues pw*xn od by or an <br />bebWof css am named Inswed. sack ilmuonce as u ofronied by this policy is pirnwy and is aw <br />aild6uuaal to orcanaribnling with any Gib" iwraax wtried by OF fordw be atitof the <br />additional instaeds. <br />I This ukwwKv ayq m sgxw, holy b each im'atd isg ima wham claim iv matt or <br />sail 6 bosgM except with scapccs m the I Pany'S fiaitr of liabiitr. the irxbatioa of any <br />person or ownisWian as as bayed shell ant afrect airy 60it wbich such palm or organi>atw m <br />womb havcas a daimaa irmn w in indw. <br />4. Widr rMgtwa to the adtktiond anac" this hrtanmce stmt trot be cancilk 1. or <br />materb* rtdaeed m eowxagc w lbaks exeeps after tidy (30) days written atWM has boss <br />given in the City of Santo Ana. 20 Civic,C bvm Pkmk State Ana. Califemis 92'10!. <br />(Completion of do following, including cotntwsiphwma. is nquuaed to onake dus adorscarnt <br />efroctift 1 <br />areetive 1/1/05 , dws todoseetoa form as a law of <br />Policy A --A6f1ed79H77:i -l�5 <br />L tw to �atrrs i rata IS cstpg or sntrl7, 14A <br />Nam Insatd <br />Cauaasigwd by <br />Audtwlxd 14prmutmttivt <br />APPROVED AS TO FORM <br />h 2 <br />aura Stitt Sheedy�" -"` <br />- A"'i tact City Attornev <br />E01EO 39va 30dMI33439 bogs -siZ -6176 TS:EI 99@Z /51 180 <br />