1989-0707_BOTACO, INC._Insurance EndorsementLIABILITY ENDORSEMENT
CITY OF SAN 3UAN CAPISTRANO
COMMUNITY REDEVELOPMENT AGENCY
32400 Paseo Addanto
San ]tan Capistranq California 92673
ATTN.
A. POLICY INFORMATION
Endorsement # L6394
1. Insurance Company CANADIAN INs• OD. of CALIF; Policy Number GLA 559216
2. Policy Term (From) 6-13-89 To 6-13-90 ;Endorsement Effective Date 7-7-89
o INC•
3. Named Insured KYrA
4. Address of Named Insured 27455 ORMA MY, SAN JUAN CAPIMAND, CA 92675
3. LImit of Liability Any One Occurrence Aggregate 1,000,000. CS[
General Liability Aggregate (check one:)
Applies "per location/project"
Is twice the occurrence limit
6. Deductible or Self -Insured Retention (Nil unless otherwise specifiedk
7. Coverage is equivalent to:
Comprehensive General Liability form GL0002 (Ed 1/73)
Commercial General LIabilIty "claims -made" form CG0002
8. Bodily Injury and Property Damage Coverage is:
"claims -made"
X "occurrence"
If claims -made, the retroactive date Is
B. POLICY AMENDMENTS
X
This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsistent
statement in the policy to which this endorsement is attached or any other endorsement attached
thereto, it is agreed as followx
1. INSURED. The City and the Community Redevelopment Agency, its elected or appointed
officers, officials, employees and volunteers are included as insureds with regard to damages
and defense of claims arising from: (a) activities performed by or on behalf of the Named
Insured, (b) products and completed operations of the Named Insured, or (c) premises owned,
leased or used by the Named Insured.
2. CONTRIBUTION NOT REQUIRED. As respects: (a) work performed by the Named Insured
for or on behalf of the City; or (b) products sold by the Named Insured to the City; or (c)
premises leased by the Named Insured from the City, the insurance afforded by this policy
shall be primary Insurance as respects the City, its elected or appointed officers, officials,
employees or volunteers; or stand in an unlieoken chain of coverage excess of the Named
Insureds scheduled underlying primary coverage. In either event, any other insurance
maintained by the City, its elected or appointed of ficers, of ficials, employees or volunteers
shall be in excess of this insurance and shall not contribute with it.
(OVER)
3. SCOPE OF COVERAGE. This policy, if primary, affords coverage at least as broad as:
(1) Insurance Services Office form number GL 0002 (Ed. 1/73), Comprehensive General
Liabillty Insurance and Insurance Services Of Tice form number GL 0404 Broad Form
Comprehensive General Liability endorsement; or
(2) Insurance Services Office Commercial General Liability Coverage, 'occurrence"
form CG 0001 or "claims -made" form CG 0002; or
(3) If excess, affords coverage which is at least as broad as the primary insurance
forms referenced in the preceding sections (1) and (2).
4. SEVERAWLITY OF INTEREST. The insurance afforded by this policy applies separately to
each insured who is seeking coverage or against whom a claim is made or a suit is brought,
except with respect to the Company's limit of liability.
i. PROVISIONS REGARDING THE RVSURED'S DUTIES AFTER ACCIDENT OR LOSS. Any
failure to comply with reporting provisions of the policy shall not affect coverage provided
to the City and the Community Redevelopment Agency, its elected or appointed officers,
officials, employees or volunteers.
6. CANCELLATION NOTICE. The insurance afforded by this policy shall not be suspended,
voided, cancelled, reduced in coverage or in limits except after thirty (30) days' prior written
notice by certified mail return receipt requested has been given to the City. Such notice
shall be addressed as shown in the heading of this endorsement.
C. INCIDENT AND CLAIM REPORTING PROCEDURE
Incidents and claims are to be reported to the insurer at:
ATTN:
(Title) Department
SEA OWr INSURANCE AGENCY, INC.
Company
31726 RANCHO VIM RD #213
Street Address
SAN JUAN CAPISMW, CA 92675
(City) State Zip Code)
( 714) 831-2963
elephone
D. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER
I, JAMES E. PAUL (print/type name), warrant that I have authority to bind the below listed
insurance company and by my signature hereon do s�bind,.this company.
RE OF AUTHORI2:ED REPRESENTATIVE (origfinal
required on endorsement furnished to the City)
CMANMAT ICN: SFA CDAsr IN9JRA= TITLE• RmsmNI
p33MSS: 31726 RXKW VEM 10 11213, SAN JUAN CAPD, CA TELEPMC: (714 ) 831-2963