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<br />, <br /> <br />12/19/2~26 12:25 <br /> <br />7145278898 <br /> <br />STATE FARM <br /> <br />PAGE ~2 <br /> <br />SK PorIOY No. 92-GA-B133-B <br /> <br />FE_ <br /> <br />SECllON II ADDITIONAL INSURED ENDORSEMENT <br /> <br />~ <br /> <br />Policy No.: 92-GA-B133-B <br /> <br />......... InsuNd: <br /> <br />GEORGE, MARIB <br /> <br />Addiliana/ Insured (Inotude addrw8l: <br /> <br />CITY OF SAln'll. _ <br />'1'SIlIR OFFJ:CBRS & EMPLOYImS <br />see W Sl\IlTA IllfA BLVD STE 200 <br />SlIJITA JlRlI. CA 92701 <br /> <br />WHO IS AN 1NSURl!D, under SECTION II DESIGNA noN OF INSURED, is 8Il18I'lded to in<:lude as an insured the <br />AIIdilIonaI Insured shown above, but only to the extent thalliabftity is Impo8ed on that AddIIlonal Insured solely <br />~ of your WOI'Ic p..o1oolled for that Additlonellnlured shown sbove. <br /> <br />Any insUra.- ........- '" the AddftIonaIlnaured shall only apply wtth respect '" a claim maae or a suit brought for <br />damage6 for which you are provided ~. <br /> <br />The PrlmaIY Insu/'B11Qe coverage below applies only when there Is lIl1 'X' in lf1e box. <br /> <br />m PrinIlIry In_ce. The lnSU/'Bl1Qe provided 10 tile Additional Insured showr1 above shall be primalY <br />instr.Ince. My Io$UI1II1C8 carried by the Additional rn~ shall be noocontrIbulory with respect 10 <br />coverage provided 10 you. <br /> <br />All olf1er paIioy provisions apply. <br /> <br />~ <br /> <br />t<'?8 ~ I? <br /> <br />Printed In u.$.A, <br /> <br />