Laserfiche WebLink
0694804 GREAT AMERICAN INSURANCE CO <br />Administrativa Offices <br />07/04 Ed <br />CG 20 26 . <br />301E 4th Street ( ) <br />iRLAT CiZcinnati OH 45202 -421}1 <br />AMERICAN, 513 ph Policy: PAC 033 -09 -78 00 <br />INSURANCE GROUP <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -- DESIGNATED OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />5UHI=UUL <br />ame of Person or Organization: <br />OUNTY OF ORANGE, ITS ELECTED AND APPOINTED OFFICIALS, <br />FFICERS, EMPLOYEES, AGENTS AND VOLUNTEERS <br />OUNTY OF ORANGE, ORANGE COUNTY <br />'ORKFORCE INVESTMENT BOARD <br />TTN: AMY HARAYDA <br />300 S. GRAND AVE., BLDG B, 3RD FL <br />ANTA ANA, CA 92705 <br />E: WIA YOUTH PROVIDER AGREEMENTS #Y6 -2W -12 AND Y6- CGRP -12. <br />(HERE REQUIRED BY WRITTEN CONTRACT, <br />EVISION OF OTHER INSURANCE CLAUSE <br />P —MARY INSURANCE: <br />THIS INSURANCE IS PRIMARY AND ANY OTHER INSURANCE MAINTAINED BY <br />SUCH ADDITIONAL INSUREDS IS NONCONTRIBUTING WITH THIS INSURANCE <br />AS RESPECTS LEGAL LIABILITIES OR CLAIMS CAUSED BY, ARISING OUT OF <br />OR RESULTING FROM THE ACTS OR OMISSIONS OF THE NAMED INSURED, OR <br />OF OTHERS PERFORMED ON BEHALF OF THE NAMED INSURED. <br />LL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED, <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />SECTION II - WHO IS AN INSURED is amended to include as an Additional Insured the person(s) or <br />organization(s) shown in the Schedule, but only with respect to liability for "bodily injury," "property damage" or <br />"personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or <br />omissions of those acting on your behalf: <br />A. in the performance of your ongoing operations; or <br />B. in connection with your premises owned by or rented to you. <br />Copyright, Insurance Services Office, Inc., 1984 <br />ICG 20 26 07/04 (Page 1 of 1 ) <br />0 <br />