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<br />. . <br /> <br />Uability Insurance <br /> <br />Endorsement <br /> <br />Policy Period: <br />Etrcct/Ve Dale: <br /> <br />Policy Number. <br /> <br />InslJl9d: <br /> <br />10-1-99tolO-l~ <br />10-1-99 <br /> <br />35755795 <br /> <br />On-Site Fabricare Service, lLC <br /> <br />Name of Company. Great Northorn Insurance Company (Chubb) <br />Dat& lsaue(/. <br /> <br />This Endonlemlll'1t appll" \0 the followlng forml: <br /> <br />Genllral LIability <br /> <br />Under '^"'" 1111lSUI'ed The FoIIowfng PfO'Iieion 10 Added: <br /> <br />Who Is Insured <br /> <br />Ownenr, LNS." Or <br />Coot1Jl1;tOrS <br /> <br />Any pel1lOn or IlflllI'Ilzalioo deslgnaled below Ie "" InSlnd, bul only with respect \0 thalr Ilablnty <br />M owner, 18_ or conI1ac:tgr .nsin9 oUl 01 your ongolng opendillns perrorm8d lor IhEll inSlnd. <br /> <br />DesllJIated Owner, L....ee or Contractor <br /> <br />11lF. CllY OF SANTA ANA. ITS OFFICERS, AGENTS & Io:MPLOYEES <br /> <br />A" other terms and condltlone remaln unClWlged. <br /> <br />/wIhorI;:Qd RepresetlIaIiw; <br /> <br />~/_ J" ~ <br /> <br />U3bJIily In8IIlfll1Gf1 AddiIJotr8/ lMurI1d . Qwn&I.s. I _n Or COIlI19c/Jm <br />Form 80-02.z3O!S(E~4-94) Endorsoment <br /> <br />lasl pago <br />p.gv t <br /> <br />GO/ZO 'd 'ON KlJ:I <br /> <br />!lit 91:110 craM OOOZ-9Z-W <br />