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ATTACHMENT"B" <br />SAMPLE ADDITIONAL INSURED ENDORSEMENT <br />Insurance Company <br />This endorsement modifies such insurance as is afforded by the provisions of Policy # <br />relating to the following: <br />1. The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; its <br />officers, employees, agents and representatives are named as additional insureds <br />("additional insureds") with regard to liability and defense of suits arising from the <br />operations and uses performed by or on behalf of the named insured. <br />2. With respect to claims arising out of the operations and uses performed by or on <br />behalf of the name insured, such insurance as is afforded by this policy is primary <br />and is not additional to or contributing with any other insurance carried by or for the <br />benefit of the additional insureds. <br />3. This insurance applies separately to each insured against whom claim is made or <br />suit is brought except with respect to the company's limits of liability. The inclusion <br />of any person or organization as an insured shall not affect any right which such <br />person or organization would have as a claimant if not so included. <br />4. With respect to the additional insureds, this insurance shall not be cancelled, or <br />materially reduced in coverage or limits except after thirty (30) days written notice <br />has been given to the City of Santa Ana, 20 Civic Center Plaza, Santa Ana, <br />California 92701. <br />(Completion of the following, including countersignature, is required to make this <br />endorsement effective.) <br />Effective <br />Policy # <br />Issued to <br />Name Insured <br />Countersigned by <br />13 <br />the endorsement form as part of <br />25A-34 <br />