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<br />l.).ec 12 OG C1k~3:;p <br /> <br />s.anlta ana prcs.a <br /> <br />'~/.: 4.5'7:1. 423~S <br /> <br />p. ~:l <br /> <br />. <br /> <br />. <br /> <br />,,"'-< <br /> <br />'~I~- ~ <br /> <br />.., <br /> <br />- <br /> <br />This Endorsement changes the Commercial Liability Policy. I'LEASB read it carefully. <br /> <br />This e'kiol5~m""i, off.cove on {fJI29!2Q(JQ at SllInda:d lime shown in the Policy Oe;:laratiollS, fomlE a part of Policy <br />NUUlber JYG}3256OC-99 ISsued to MillUt De! Cantrell Gudino 3838,3 by General Star Indemnity, , <br /> <br />Enuorsement Nunlber 001 <br /> <br />This elldon;ement modifies insurallce provi.ded for under the filllowing: <br /> <br />COMMUKiAi. GE'l:FI;>AL LlAHILlIY COVERAC';E PART <br /> <br />ADDITIONAL INSlilU:n . DLA.NKET FORM <br /> <br />\VHO IS AN INSURED (Section 11) is am(:ndcd to include us an insured the per.-;on(s) Qr DrganizatiQu(s) ~hnwn in the <br />Schedu[r: ~s an. insured but only with respett to !iavilit;r, arising Gut of your op.:-r.af!(ln,s or pn.~mises owned by or remed to <br />you. <br /> <br />NalUe fJl' Persoll or Orgaulzation <br /> <br />. <br /> <br />Cit)' of Sant3 Al:l~ <br />lIS Officc"s, Emplo)'ees, Agents, Volunteen lInd Rel',"",en!"n",. <br />20 Civic Piau <br />Saala An.1, CA 92701 <br /> <br />Ail certificilteS of insurance holders )'OU have agreed tu inci~de as an insured Plior to an "OccUl'rence" or <br />oHense <br /> <br />(8-97) <br /> <br />APPROVED AS TO FORM <br /> <br />~' tfjWfi <br />I. NJA It~ F <br />I C f Assist nt Oity A~ <br />