Laserfiche WebLink
THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />CA 20 48 02 99 <br />DESIGNATED INSURED ENDORSEMENT <br />The endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGEFORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by the endorsement. <br />This endorsement Identifies person(s) or organization(s) who are "Insureds" under the WHO IS AN IN- <br />SURED provision of the Coverage Form. This endorsement does not alter coverage provided in the Cov- <br />erage Form. <br />This endorsement changes the policy effective on the Inception date of the policy unless another date is <br />Indicated below. <br />Endorsement Effective <br />Policy Number BAS56380327 <br />Named Insured HdL Coren and Cone <br />- 9-• <br />�s!`''�' <br />Countersi ned b <br />(Authorized Representative) <br />SCHEDULE <br />Name of Person(s) or Organization(s) <br />The City of Santa Ana, its officers, employees and agents <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declara- <br />tions as applicable to this endorsement.) <br />Each person or organization shown in the Schedule Is an 'Insured" for LIABILITY COVERAGE, but only to <br />the extent that person or organization qualifies as an "insured" under the WHO IS AN INSURED provision <br />contained in SECTION II of the Coverage Form. <br />CA 20 48 02 99 Copyright, Insurance services office, Inc„ 1998 Page 1 of 1 <br />