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<br />v.. L~. {.Ii,,:t <br /> <br />//MI <br /> <br />~A\:.~ ~~~~: ~0:~~v <br /> <br />r\ :'. ~'! c. ' <br /> <br />L <br /> <br />- <br /> <br />ENDORSEMENT <br />NO. 2 <br /> <br />Western Heritage <br />IIISU",UICV {d1mpIWY <br /> <br />ATTACHEOTC; A~D ENDORSEMENT EFf'E:CTJVE" DArE" <br />FORM/NO A PART OF (12:0'1 Jl.M. STAPllfJAA01IMEJ IIIAMED INSURED AGENT NO. <br />POLlCV NUMllE"R <br />SCP0610371 00/0:1/2006 ORANGE COUNTY CHILDRENS THERAPEUTIC 04040 <br /> ART CENTER, INC. <br /> <br />(The above/nlormatlon Is required only when !Ills endorsement Is Issued subseQuent to preparation olthe policy.) <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br /> <br />In consideration of tbe premium charged, it is hereby understood and agr'eed that the <br />policy is. amended as per the attaChed form CG 20 10 (7/04). <br /> <br />It 18 further understood ana agreed that _in consideration of an addltlonDl premium of <br />$150.00, form CG 20 10 (7/04) is amended ill pan to include the folloWing verbiage, <br /> <br />"This insurance ahall be primary and noncontributory but only in the event of the Named <br />Ihsured's bole negligence." <br /> <br />The primary verbiage applies to the follOwing entity only: <br /> <br />C1Cy of Santa Ana <br />P.O. Box 190B <br />Santa Ana, CA 92702 <br /> <br />Additional premium: <br />State tax: <br />Stamping fee: <br /> <br />$150.00 (Fully Uarned) <br />$ 4.50 <br />$ 0.26 <br /> <br />Total Amount Due: <br /> <br />$154.76 <br /> <br />/ <br /> <br />. d . <br />~~> <br />N):,\:) /, f)/__ <br />...J L..1 f/:..~/ <br />.- ."" <br />:\O'-'.u'. .' <br />~ S ,..,' <br />f' \:". f'_cu <br />\..\S.,\ (,I\~ <-{ ) <br />.,\~\ ~ <br />-SY:.> <br />to.' <br />I ~ 0 . <br />\:. <br /> <br />8M/NT <br />10/20/2006 <br /> <br />All otherTerms and Conditions of this Policy remain unchanged. <br /> <br />4-,- e ~~,i <br /> <br />AUTHORIZED R.PRESENTATIV. <br /> <br />I <br /> <br />DATE <br /> <br />WHI 20-01 06 (~/99) <br /> <br />INSURED <br /> <br />