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POLICY NUMBER: PHPK2127804 <br />COMMERCIAL. AUTO <br />ISSUE DATE: 6.2.20 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />An <br />• <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 1. No liability Is assumed by that person or or - <br />includes the person or organization indicated below, ganization for the payment of any premiums <br />but only for his, her or Its liability because of acts or stated In the policy or earned under the policy. <br />omissions of an :insured under paragraphs a. or b. of 2, In the event of cancellation of the policy, writ - <br />that provision, subject to the following additional provl- ten notice of cancellation will be mailed by us <br />sions: to that person or organization. <br />Person or Organization <br />The City of Santa Ana, Its officers, employees, agents, <br />volunteers and representatives <br />Address: <br />City of Santa Ana <br />20 Civic Center Drive 4t' fir. <br />Santa Ana, CA 92702 <br />REVIEWED & APPROVED <br />By Risk MAN.AGemr.Nt DivisioN <br />JUL 2020 <br />,4ragie r`�c�vt:cio �� <br />CA T3 01 02 99 Page 1 of 1 L7 <br />