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Feb 11 C3 12 . 52p C 1 of StocktonPW - Permit 12C '. 37 - 8901 p . 2 <br /> arrsaxsDo <br /> POLICY NUMBER: COMMERCIAL GENERAL UA5ILJ7Y <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CARE4 W40 <br /> FULLY <br /> ADDITIONAL INSURED - OWNERS, LESSEEf R <br /> CONTRACTORS FORM S ) <br /> This endorsement modifies insurance provided under the fcllowing: <br /> COMMERCIAL GENERAL UABILiTY COVERAGE PART. <br /> SCHEDULE <br /> . Name of Parson or Organization: <br /> CITY OF 570C=M, I73 OFFICERS, AGSM AND B( :DYm <br /> 5 S . Lindsay Street <br /> =KTOXi CA 952:1z <br /> Of no entry appears above, information required :o co this a emement will be s n in the Deeiara- <br /> lions as 8ppficable to this endorsement.) <br /> WHO IS AN INSURED (Section 11) is amende o in de as an i <br /> toed the nor organization shown <br /> G but eniy with respect to iiah' arisi ua or "yea: <br /> in the SChcdul work° 4or that Insured by or for you, <br /> attlre <br /> An o zed Representative <br /> CITY OF STOC: KTc3N <br /> r4 J .�-� C--� f diANNE GAEGORIUS <br /> RISK MANAGEMENT 3-CTIOM1 <br /> 4 <br /> gECk'.E_ cE?•; G'eEnE�aRTV;FH- <br /> V I .Tv DSA ANN£x <br /> LI�VCSA9- <br /> e E. Y Si 6s� 6 <br /> STp„nTON. Ca a� 'FON.; ?.�9i7]:-9629 <br /> W <br /> CC 20 Ip 11 85 post-if Fax Nota 7871 oa16 � j page9� <br /> ToFro G /Uuyh 'tYe15$ <br /> Ca.:DEpt. Cs . <br /> Phones Phcne # <br /> F2X Fax 0 <br />