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37/28/2009 15:31 7145278898 STATE FARM PAGE 03 <br />CORD POUCy NO,: 92-(3A 8133-8 FE- <br />8600 <br />SECTION 11 ADDITIONAL INSURED ENDORSEMENT <br />Policy No.: 92-GA 8133-8 <br />Named Insured: GEORGE, MARIE DBA: ACT ONE ACADEMY OF DANCE <br />Additional Insured (include address): <br />CITY OF SANTA ANA <br />THEIR OFFICERS & EMPLOYEES <br />888 W SANTA ANA BLVD STE 200 <br />SANTA ANA CA 92701-4561 <br />WHO IS AN INSURED, under SECTION 11 DESIGNATION OF INSURED, is amended to include as <br />an insured the Additional Insured shown above, but only to the extent that liability Is Imposed on that <br />Additional Insured solely because of your work performed for that Additional Insured shown above. <br />Any Insurance provided to the Additional Insured shall only apply with respect to a claim made or a <br />suit brought for damages for which you are provided coverage. <br />The Primary Insurance coverage below applies only when there is an "X" In the box. <br />j Primary Insurance. The Insurance provided to the Additional Insured shown above shall be <br />primary insurance. Any Insurance Carried by the Additional Insured shall be noncontributory <br />with respect to Coverage provided to you. <br />All other policy provisions apply. <br />FE-0609 Pdnled In 11.5.A, <br />