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<br />. <br /> <br />'- <br /> <br />..., <br /> <br />A~~-27-2e.l le,ee AM OTT&R$Q~ & ~8.QC1.TES <br />. <br /> <br />"'14'588684 <br /> <br />~..IiI. <br /> <br />IXJIIIJIT B <br /> <br />"nnTTtON..u. INIlURRn llNDaURU'J!NT <br />POll COMMJ:'llrUT. ~"'. LURILrrv Pin .tv:J: <br /> <br />huurance Company ~rit'.l'ln manLl.1-SnhA.?J"Vl Mu.~l <br /> <br />Thi. endonelNll\t modiflea IlUCh IllIUTInlle .. is alfordld by lhe provltiolll of Polley <br />* 7~'1ciI()~31 - DO reIalina to tile fil&wilJ,J: <br /> <br />1 , The City of SIlIta kla. 30 CIviC! Center PIau, 5111ta AD., C&lit'onlia 92 70 J; Iu <br />of!IeeI.. employees, ...nll, volllllleerlaM rep,.....lClIItl_ are lIIllIecI u 8ddltlOlll.llnlUred. <br />('acldillonallnlUl'lclt'? wllh resarcl to liability and deteIlI. of'auill ari.inS &-om the operlliona <br />wt IlIeI performed by or on bobalfotthe lIIllIed llllUred. <br /> <br />:Z, Willll'llplCt 10 Cllalllll Wlna out of Ill. o!*lllon. tIld lIIU ptdottnecI by or on <br />beha1t of the nmnld inSllred, IIlch IIIIUt11lee II la &.ft'orded by lhl. poU;y i. prirnuy and I. not <br />addIllona! to or eontrlbulina with any oeher illlUrlllC8 earned by or for the _fll olth. <br />addltiOlllllnl\ll'edl. <br /> <br />3. TlIi.llllllranCf appu.. ltpIrawly 10 wbluured a..ln'l whorn clllm I. made or <br />suit I.t brought except with I'IIPect 10 ~be oomPllly'lllmIlS or 1Ia1ll11ty. The Indutioll of any <br />penon or orpZ'JDtiOll u an iJII&nd Iha1I not IfI'Iot any riJht which auch person or oraaniMtion <br />would h.ve II . oIaimanl if' nOllO Included. <br /> <br />4. Wllh r.pecllo tha addhional ~ till, InlllflllCl. 111&11 nOl be cancelled, ... <br />'1-"1111) "lrTi ,. rauf"qlf Ir 1111111 _ept 18. thhty (30) day. written IlOtice lw betn <br />li\l1ln to lhe City ofSIIllI Aft.. 20 Civic Cemer Piau, Senta Ana, Calilbmia 92701 <br /> <br />(Completion ofthc fbllowlnl, includill8 ;olll1ilTaipatura, ill'lqulrecI to make t1ti. endonement <br />.~YI.) <br /> <br />EffOCltivo ZLt 1.1 / ~ I . thI. endorllOtllald f'orm .. I plrt of <br />Policyil ~~I_~ <br />ISI\Ied to Jr A j.'\fes <br />Named IlIIUI'Id <br /> <br />AudIorize4 J..p1'll'lIl&l.ive <br /> <br /> <br />Coulllel1lanecl by <br /> <br />10 <br /> <br />,CO./tOO", HO,. <br /> <br />~ilV!~,~:=V " ~r"',Hl":''lo'' I~f'T'V~'" <br /> <br />.,....................... ........- ....- -..--- <br />