Laserfiche WebLink
POLICY NUMBER: ACVS1325Z0 <br />COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED FOR <br />COVERED AUTOS LIABILITY COVERAGE <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage <br />provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: <br />Endorsement Effective Date: <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />City of Santa Ana, its officials, officers, <br />agents, employees and volunteers <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92701 <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />Each person or organization shown in the Schedule is <br />an "insured" for Covered Autos Liability Coverage, but <br />only to the extent that person or organization qualifies <br />as an "insured" under the Who Is An Insured <br />provision contained in Paragraph AA of Section II — <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph 13.2. of Section I — Covered Autos <br />Coverages of the Auto Dealers Coverage Form. <br />CA20481013 © Insurance Services Office, Inc., 2011 <br />Ride Manarmnt DIVISIon <br />,S REVIEWED&{{APPROVED BY. <br />8 F�.VFrµ,e f�. Vl4 <br />Risk Management Analyst <br />56929719 1 20-21 GL-AL-OL-WC I Sherry Young 1 0/9/2020 3:02:47 PM (PDT) I Page 3 of 8 <br />