1990-0613_BOTACO, INC._Insurance EndorsementUABUTY ENDORSEitENT
aTy or sAN WAN 'COMMUNITY REDEVELOPMENT AGENCY
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' +`/4,.v" PoucY INFORMATION ''a'1 1, : ^- ;, ;::'.} a ;! ►Gi R .�1 rri! ► 1+r '.° '1 Endorsement / 1
insurance Company U.S.F.&G. INSURANCE, poilCyNumber 1CP115307038
L'' Policy Term (From) - - o b-13-91 :Endorsement Effective ate -
3, Named Insured B
Address of Named Insured. , SAN JUAN CAPISTRANO,
.. " Lint oj,Liablllty Any One OccurrencclAggregate 4 1,000,000, CSL
General Liability Aggregate (check ones)
Applies "per lotlon/project". �
u .
Is twice the occurrence Amit
6. Deductible or Self -Insured Retention (NU unless otherwise sponWed)t S
..".; '`.' 7:'... +,Gtver4ge b 4auivalent tot ", ' . ' .. .' . `- • ..
Comprehensive General Liability form GL0002 (Ed 1/73).
xx
Commercial General Liability "claims-mede" form CGO0,02
>L Bodily Injury and Property Damage Coverage Ins
OcIalms-made"
"accurrenre"
If claims -made, the retractive date b
L ,POLICY AMENDMENTS '
This endorsement is Issued In consideration of the policy premium. Notwithstanding any Inconsistent
statement In the._pollcy to which this endorsement Is attached or any other endorsement attached
thereto. It Is agreed as followst
L 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 front (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 rdspectu (a) work performed by the Named Insured'
for or on behalf of the Clty; 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, offlclals.
employees or volunteersl or stand In an unbroken 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 a pointed off[44ers, officials, employees or volunteers
shall be In excess of ttus Insurance and Yall not contribute with lt.
3: SCQPA OIs �Q1(f:RAGE.1 Th�s pollcy,'if. primary, affords coverage at least as broad ast
(1) Insurance Services Of ace form number GL 0002 (Ed. 1/73)0 Comprehensive General
Liability Insurance and Insurance Services Office form number GL 0404 Broad Form
comprehsnslve General Liability endorsement] or
Insurance Services Office Commercial General ImIagUlty Coyerage, "occurrence"
form CG 0001 or "claims -made" form CG 00021 or
If excess,"alfords coverage which. Is at least as broad'as the primary Insurance
forms referenced in the preceding sections (1) and (2).
{. - SZVURAWTY 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 Ilablllty.
I PROVISIONS REGARDING THE INSURED'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,
o94c444, employees or volunteers.
i. CANCELLATION NOTICE. The Insurance afforded by this- policy shall not be suspended,
voldod, cancelled, reduced in coverage or In limits except atter thirty (30) days' prior written
notice by certitled mail return recelpt 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 we to be reported to the Insurer at;
OMNI
CTItle)Department
SEA COAST INSURANCE AGENCY, INC.
(Company)
31726 RANCHO VIEJO RD 11213
treet Addres
SAN JUAN CAPISTRANO, CA 92675 -
(City) (S
2675 ty tat Z p Cad oT
714 831-2963
(Telephone)..
i
p. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER
JAMES' 5,., PAUL (print/type name), warrant that l have authority to bind the below listed
insurance company and by my sigi4twe hereon do sq43h4 this company'.
"SIGNATYRE Off AUTMORIZED REPRESENTATIVE (original,
44natusle required on endprsement,furnhhed to the City)'
CKANIZATIM SEA COAST INSURANCE , TI7LEt -,PRESIDENT
A=,U5s 31726 RANCHO VIEJO RD11213, SAN JUAN CAPISTRANO Tl1FPFIi�EI 141 831-2963 ,
r