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<br />rt<U'1 Ii <br /> <br />t-I-LX. NU. ; (lq-~ (--0;)4=-, <br /> <br />.=Ie:: .L:7 4::.~~.c:. .L.....t:N"1l1 ~~ <br /> <br />;; <br /> <br />'"'" <br /> <br />...,; <br /> <br />ADDITIONAL INSURED ENDORSEMENT <br />FOR COMMERCIAL UENERAL LIABILITY POLICY <br /> <br />In~ur.mce Company <br /> <br />Great American Insurance Company <br /> <br />This endorsement modilies such insurance as is afforded by the provisions ot' Policy <br /># PAr.6536218 relating to the following: '. <br /> <br />1. The City of Santa Ana, 20 Civic CenterPla7..a, Santa Ana, California 92701; its <br />officers, employees, agents, volunteers and representatives are named as additional insureds <br />("additional insureds") with regard to liability and defense of suits arising from the operations <br />and use.,~ performed by (lr (In behalf of the named insured. <br /> <br />2. With respect to claims arising out of the operations and uses perfo~d by or on <br />behalf of the named insured, such insurance as is afforded by this policy is primary and is not <br />additional to or contributing with any other insurance carried by or for the benefit of the <br />additional insureds. <br /> <br />3. This insurance applies separately to each insured against whom claim is made or <br />sui~ is brought except with rcspect to thc company's limits of liability. The inclusion of any <br />person or organization as an insured shall not affect any right which such person or organi7.ation <br />would have as a claimant if not so included. . . <br /> <br />4. With respect to the additional insureds, this insurance shall nolba cancelled, or <br />materially reduced in coverage or limits except after thirty (30) days written notice has been <br />given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701. <br /> <br />(Completion of the following, including countersignature, is required to make this endorsement <br />effecti ve.) <br /> <br />Effective <br />Policy # <br />Issued to <br /> <br />Mav 3. 2003 , this endorsement form as a part of <br />PAC6536218 <br />M~rr:y t!Cltl<;e 'I'ransitional Livinq Center ETAL <br />Named Insured <br /> <br />Countersigned by <br /> <br />'i5~'~~ <br /> <br />Authorized Represen ative <br />Robin Hatfield - Broker <br /> <br />APPROVfOD .' '. <br />. / ". ~ !-,~ 10 FORM <br />;{2"'Y; . <br />, '".' <br />- ,.:,.. f {; {1 (. <br />.-'1Ur,l Shccdv -7______ <br />~ Ill/tv C' . / <br />. ~ ..ry At(OfnQ\, <br />