1990-0613_BOTACO, INC._Insurance EndorsementL ILITY ENDORSEiIENT
iu,.-hd r• �s+sl i. nes»voy ; ? CrrY OF SAN WAN CAPLSTRANO .
CDlZiUNITY R.EDEVELOPfr1ENT AGENCY
32400 Pasep,Adekdo „y
(t�•1lY A`QYh1 Jah McL,:h:;7 m'2o1 +:211 Ua san Capktssnos sf Ord#
i. yhin�.2JA CITY CL R�xOFf I'C� �t j :'+• S
i-''.. X~ ... ��. .n2e.'. f �! iF;-,�. .,v'. .�.) 9:.i11(i i'•71'I h'+i x'•11 p?Ir+ti
A, ICY iNPORMATION '' Endor:emsnt i
insurance Company
U.S.F.&G. INSURANC ICP115307038
• . , 1.•,. •.
2.' Policy Term (From) - - o -Polley Number ;Endorsement F.IlectiVe Oats -
3. Named Insured $
44,1 Address of Named Insure • , SAN JUAN CAPISTRA ,
3. Limit of Liability Any Ona ccurrenc Aggregate 4 1 000 00. CSL
General Liability Aggregate (check ones)
_ x•_ ..� :r. ,c:
Applies "per locationlprojece,
:•, .. Is twits the occurrence limit
f. Deductible or Self-insured Retention (Nil unless otherwise specified)t
_ 7�.., .Coverage k equivalent to
'Comprehensive General Liability form GLOOM (Ed 1/73)
Commercial General Liability "claims -mads" form CG0002
ZL Bodily Injury and Property Damage Coverage In
"clalms-made"
�"'�"occurrence" .
It claims -made# the retractive date Is
B. EOUCCY AMENDMENTS "
This endorsement Is Issued in consideration of the policy premium. Notwithstanding any Inconsisten
statement In tt"ollcy to which this endorsement is attached or any other endorsement attachec
thereto, it Is agreed as follows;
L, INSUR11. The City and the Community Redevelopment Agencys its elected or appolntec
officers# officials, employees and volunteers are Included as Insureds with regard to damages)
and defense of claims arising frosm W activities performed by or on behalf of the Namec'
Insured# (b) products and completed operations of the Named Insured, or (c) premises owned,
leased or used by the Named Insured
L CONTRIBUTION NOT REQUIRED. As rdspectu (a) work performed by the Named Insurec
for or on behalf of the City; or (b) products sold by the Named insured to the Cltyl 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 unWaken chain of coverage excess of the Namec
insureds scheduled underlying primary. coverage. In either event# any other Insurance
maintained by the Clt, its elected or a pointed of It ere, of f1clals, employees or volunteers
shall be In excess of ttt�s Insurance and Mill not eontr�bute with It.
(OVER)
.r
!0 ., . ,
IV.L%
.,1. ,
si SCQpf3 OF RY�RAGE. ;T S poltey, U pr ye afford$ coverage at leant as broad au
(i) Insurance services Office term number GL 0002 (Ed. 1/73), Comprehensive General
Liability Insurance and Insurance Services Of Ilse form number GL 0404 Broad Form
comprehensive General Liability endorsamentl or
Insurance Services Office Commercial General j.�Wty Coyerage, %occurrence"
form CG 0001 or clalms-made form CG 00021 or
it excess,'affords coverage which is at least as broad'as the primary Insurance
forms referenced In the preceding sections (1) and (2j.
{. SEVERANUTY OF INTEREST. The Insurance afforded by this policy applies separately to
each Insured -Who is sacking coverage or against whom a claim is made or a suit is brought,
except with respect to the Company's limit of liability.
3. PROVISIONS REGARDING THE 9NSURWS DUTIES AFTER ACCIDENT OR LASS Any
failure to comply with reporting provisions of the policy shall not affect coverage provided
to the City and the Community Redevelopment Agencys Its elected or appointed officers,
officals, employees or volunteers.
C CANCZLLATION NOTICE. The Insurance afforded by thla•pollcy shall not be suspended,
voided, cancelled, reduced In coverage or in limits except after thirty (30) days' prior written
notics by certified mail return receipt requested has been given to the City. Such notics
shad be addressed as shown in the heading of this endorsement.
C. INCIDENT AND CLAIM REPORTING PROCEDURE
It>cidonts and claims are to be reported to the Insurer au
ATTNt
(Title) Department
_...._. SEA COAST INSURANCE AGENCY, INC.
ompany
31726 RANCHO VIEJO RD #213
crest Addres
SAN JUAN CAPISTRANO, CA 92675•• v.,
(City) tat Z Ip od
v 714 831-2963
D. SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER
".fAMES' E':' PAUL (ptint/type name), warrant that I have authority to bind"the below listed
Inswancs company and.by my SI&Is hereon do SRAUM this company,
N A ORIZED EPR SE ATi (orlgglnal,
e required on gndcrsement,furnlshed to the Clty)
GWANIZATiCN; SEA COAST INSURANCE TLTLEI PRESIDENT
ASYitESSt 31726 RANCHO VIEJO RD1i213, SAN JUAN CAPISTRANO TELEPKM (71'41 '831-2963 ,