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TUSTIN IRVINE MEDICAL GROUP 2 -2012
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TUSTIN IRVINE MEDICAL GROUP 2 -2012
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Last modified
9/26/2012 9:54:01 AM
Creation date
7/16/2012 2:58:08 PM
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Contracts
Company Name
TUSTIN IRVINE MEDICAL GROUP
Contract #
N-2012-080
Agency
PERSONNEL SERVICES
Destruction Year
0
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B,'P704154 JOHN G ALEVI ZOS DO <br />EFFECTIVE: 08/12/2012 PROCESSED: 06/08/2012 <br />POLICY NUMBER: BUSINESSOWNERS <br />BP 04 48 01 <br />?s <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -DESIGNATED PERSON <br />OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE <br />Name of Additional Insured Person(s) Or Organization(s): <br />CITY OF SANTA ANA <br />ITS OFF ECERS, EMPLOYEES, <br />AGENTS, VOLUNTEERS AND <br />REPRESENTATIVES ARE NAMED AS <br />ADDITIONAL INSUREDS WITH <br />REGARDS TO LIABILTY AND <br />DEFENSE OF SUITS ARISING FROM <br />THE OPERATIONS AND USES <br />PREFORMED BY OR ON BEHALF OF <br />THE NAMED INSUREDS <br />20 CIVIC CTR PLAZA <br />SANTA ANA CA 92701 <br />Information re wired to com lete this Schedule, if not shown above, will be shown in the Declarations. <br />The following is added to Paragraph C. Who Is An Insured in Section 11 -Liability: <br />3. Any person(s) or organization(s) shown in the Schedule is also an additional insured, but only with respect to <br />liability for "bodily injury", "properly damage" or "persona! and advertisirig injury" caused, in whole or in part, by <br />your acts or omissions or the acts or omissions of those acting on your behalf in the performance of your ongoing <br />operations or in connection with your premises owned by or rented to you. <br />r <br />BP 04 48 01 06 ©[SO Properties, Inc_, 2004 Page 1 of 1 <br />o?o?evrwa
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