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<br />. 12/~3/2002 21:20 <br /> <br />7148"';38 <br /> <br /><! <br /> <br />... <br /> <br />PAGE 02/02 <br /> <br />. <br /> <br />FRO'I : <br /> <br />FRX t-D. : 714-647~9 <br /> <br />Nov. 22:~ 01:01PM P3 <br /> <br />ENDORSEMENT <br /> <br />.POLICY NUMBER: <br /> <br />CP7781601 <br /> <br />.INSURED COMPANY NAME; <br /> <br />Thomas House.Temporary Shelter <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - DESIGNATED PERSON or <br />ORGANIZATION <br /> <br />111i. endorsement modifies insu1'lInce providad uuder the followinB: <br /> <br />COMMERCIAL GENERAL UABIUTY COVERAGE PAR1' <br />SCHEDULE <br /> <br />N Gmc of Person Of OrlleJdzation; <br /> <br />City of Santa Ana and its Officers, Agents, EmploYlae5 and <br />Volunteers are named as additional insured as respects their <br />interest in connection witb tbe named insu.red. <br /> <br />(If no entry appelUS above, information rcq,uircd to complete this cndors'IDIcnt will be <br />l{hown j\1 the peollU'lltions as applicable to this endorsement.) <br /> <br />WHO IS AN T.NSURED (Section m is amended toinclude as an insure<l the person or <br />organization shown in the Schedule, but only with respeot to liability arisIng out of your <br />operations or premises owned by or rented to you. <br /> <br />IT IS AGREED THAT ANY INSURANCE MAINTAINED BY THE CITY OF <br />SANTA ANA SHALL APPLY 11'1 EXCESS OF, AND NOT CONTIUBm wlTII, <br />INSURANCE PROVIDED BY 'l'HJS POLlCY, <br /> <br />Agent'5Signature: ~ ~.~ <br /> <br />~eYJ.;~ <br />}\P ~a <br />0\110.13 <br />f>t't'l.'I <br />I c;,o?cv-. <br />\..\s~ C - p..\\O(nei <br />CG. 2010 1\ S5 p..SS\s\3n\ C\\~ ;1 <br /> <br />(2 I 8)C SAM?Lll _ Addidon.lln"'''''\ wilh Prlm.ryINQn.conlrilnl~nc L.,ngu\I~. /l.dded ~f' <br /> <br />