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POLICY NUMBER: PHPK2266697 <br />COMMERCIAL AUTO <br />ISSUE DATE: 5-2-21 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />Paragraph c. of the WHOS IS AN INSURED provision <br />includes the person or organization indicated below, <br />but only for his, her or its liability because of acts or <br />omissions of an :insured under paragraphs a. or b. of <br />that provision, subject to the following additional provi- <br />sions: <br />Person or Organization <br />The City of Santa Ana, its officers, employees, agents, <br />volunteers and representatives <br />CA T3 01 02 99 <br />1. No liability is assumed by that person or or- <br />ganization for the payment of any premiums <br />stated in the policy or earned under the policy. <br />2. In the event of cancellation of the policy, writ- <br />ten notice of cancellation will be mailed by us <br />to that person or organization. <br />Address: <br />City of Santa Ana <br />20 Civic Center Drive 41" flr. <br />Santa Ana, CA 92702 <br />�oRaN <br />} z <br />RiskMmWmedDMsfan <br />REVIEWED & APPROVED BY.- <br />f R. V;d <br />Risk Management Analyst <br />