Insurance - C & R Drains - Additional Insured Endorsement 2017-09-21Additional Insured Copy
FEDERATED INSURANCE COMPANIES
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR
SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR
AUTHORIZATIONS
This endorsement modifies insurance provided underthe following:
BUSINESSOWNERS LIABILITY COVERAGE FORM
SCHEDULE
State Or Governmental Agency or Subdivision or Political Subdivision:
COSTA MESA SANITARY DISTRICT
290 PAULARINO AVE
COSTA MESA CA 92626
The following is added to Paragraph C. Who Is An
Insured:
4. Any state or governmental agency or subdivision
or political subdivision shown in the Schedule is
also an insured, subject to the following
provisions:
a. This insurance applies only with respect to
operations performed by you or on your
behalf for which the state or governmental
agency or subdivision or political subdivision
has issued a permit or authorization.
Insured:
C & R DRAINS INC
1525 MACARTHUR BLVD STE 11
COSTA MESA CA 92626
b. This insurance does not apply to:
(1) "Bodily injury", "property damage", or
"personal and advertising injury" arising
out of operations performed for the state
or municipality; or
(2) "Bodily injury" or "property damage"
included within the "products -completed
operations hazard".
Place of Issue:
FEDERATED MUTUAL INSURANCE COMPANY
Home Office
121 East Park Square
Owatonna, MN 55060
(507)455-5200
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
BP -F-254 (08-11) Policy Number: 0696048 Transaction Effective Date: 09-21-2017