1991-1013_BOTACO, INC._Insurance EndorsementLIABILITY ENDORSEMENT
l CITY OF SAN JUAN CAPLSTR�..JO
COMMUNITY REDEVELOPMENT AGENCY
32400 Paseo Adelanto
San Duan Capistrano, California 92675
ATTN: CITY CLERICS OFFICE
A. POLICY INFORMATION
I. Insurance Company AHMICAN
2. Policy Term (From) 1
3. Named Insured
u. Address of Named Insured
5. Limit of Liability Any One O
Endorsement I 1
INs. Co. ; Policy Number01_-C-7 i-
10-13-92 ;Endorsement Effective Date -91
General Liability Aggregate (check ones.)
Applies "per location/pro)ect" XX
Is twice the occurrence limit
6. Deductible or Self -Insured Retention (Nil unless otherwise speclfied):
7. Coverage is equivalent to:
Comprehensive General Liability form GL0002 (Ed 1/73)
Commercial General Liability "claims -made" form CG0002
3. Bodily Injury and Property Damage Coverage is:
"claims -made"
'Zr� "occurrence"
If claims -made, the retroactive date is
B. POLICY AMENDMENTS
W
This endorsement is issued in consideration of the policy premium. Notwithstanding any inconsister
statement in the policy to which this endorsement is attached or any other endorsement attache
thereto, it is agreed as follows:
I. INSURED. The City and the Community Redevelopment Agency, .its elected or appointe
officers, officials, employees and volunteers are included as insureds with regard to damage
and defense of claims arising from: (a) activities performed by or on behalf of the Name
Insured, (b) products and completed operations of the Named Insured, or (c) premises owne<
leased or used by the Named Insured.
2. CONTRIBUTION NOT REAMED. As respects; (a) work performed by the Named Insurs
for or on behalf of the City; or (b) products sold by the Named Insured to the City; or (,
premises leased by the Named Insured from the City, the insurance afforded by this polk
shall be primary insurance as respects the City, its elected or appointed officers, official
employees or volunteers; or stand in an unbroken chain of coverage excess of the Name
Insureds scheduled underlying primary coverage. In either event, any other insuranc
maintained by the City, its elected or appointed officers, officials, employees or voluntee
shall be in excess of this insurance and shall not contribute with it.
(OVER)
3. SCOPE OF COVFD E. This policy, if primary, afforA overage at least as broad as:
(1) Insurance"Services Office form number GL (Ed. 1/73), Comprehensive General
Liability Insurance and Insurance Services Office form number GL 0404 Broad Furm
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. SEVERABILITY 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,
S. PROVISIONS REGARDING THE INSURED'S DUTIES AFTER ACCIDENT OR LOSS. Any;
failure to comply with reporting provisions of the policy shall not affect coverage provides`
to the City and the Community Redevelopment Agency, its elected or appointed officers,
of ficials, 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
t
Incidents and claims are to be reported to the Insurer at:
ATTN:
Title Department
SEA COAsr INSURMM
Company
34197 PCH 11202
(Street Address
Ik a POINT, CA 92629
City State Zip Code
714 489-1574
Telephone
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 so bind th9ompanM
S ATURS OF AUTHORIZED- REPR TATIVE (original
ignature required on endorsement furnished to the City)
CMANIZATICN: SEA COAST INSURANCE AGENCY, INC. TIME: PRESIDENT
AMMS: 34197 PCH 11202 DAM POINT, CA 92629 — _ TE EFI- : C14 ) 489-1574