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<br />, <br /> <br />F..b-.13~1rla3 10: 18.m From-CALI FORN IA SOUTHWESTERN I NSURANCE AGENCY 949-588-8348 <br /> <br />T-677 P,004/004 F-631 <br /> <br />THIS ENDORSEMENT CHANGES THE POllCY. PLEASE READ rr CAREFUlLY. <br />BLANKET ADDmONALINSUBED ENDORSEMENT <br /> <br />This endoJ"Sel'TlP.l't modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL llABn..ITY COVERAGE PART <br /> <br />Sf 'HI<:IIULE <br /> <br />Name of Pc.5OIl or Organiza1km: City of Santa Ana <br />1000 E. Santa Ana Blvd. #108. Santa Ana, CA 92701 <br />Any penon or o'1V"'i7JIriI)D that the named insured is obligated by virtue of a written <br />CODtI'llCt or agreement 10 provide insunmce such as is afforded by this policy and Is <br />ap!lt<>.ed by tile ClBDpIIIIY in Wlithq; witbIn 30 days of the inception of the <br />contract or agreement, or the inception oftbis POlicY. whichever is later, <br /> <br />WHO IS AN INSURED (Section D) is "......vI"" to ;nclndl> as an insured the person(s) or <br />orgl'ni.....rion(S) shown in the Schedule as an insured but only with respect tD the fullowing: <br /> <br />1. Liability arising out of your ongoing operations perfunned for that insured by or for you. or <br /> <br />2. Liability arising out of the ownership, ""';-""~, or use of premises while leased tD you. <br />or <br /> <br />3. Liability arising out of the rnairJtenanee. operation or use by you of equipment while leased <br />tD you by such person(s) or orgaDization(s), or <br /> <br />4. Operations performed by you or on your behalf for which the state or political subdivisioD <br />bas issued a pencit <br /> <br />Neither the coverages provided by this insurance Policy nor the provisions of this endorsement shall <br />apply tD any claim arising out of the sole negligence of any additional insured or any of their <br />agents/employees. <br />Primary Wording: <br />If required by written contract or agreement: Such insurance as is afforded' ,by <br />this policy shsll be primary insurance. and any insurance or self-insurance <br />maintained by the above additional insured(s) shall be excess of the insurance <br /> <br />ANF 043 (12/97) <br /> <br /> <br />FORM <br />