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M-5887 (08/2017) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED ENDORSEMENT <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />SCHEDULE —ADDITIONAL INSURED: <br />City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers <br />220 S. Daisy Ave. <br />Santa Ana, CA 92701 <br />A. In consideration of payment of the additional premium listed below, LIABILITY COVERAGE is extended to <br />include the additional insured named herein, provided that: <br />1) such insurance applies only to the ownership, maintenance or use of a covered "auto"; and <br />2) such insurance applies only to acts or omissions by you, your agents or your "employees" while such <br />covered auto is being used in your business; and <br />3) such insurance does not apply to the acts or omissions of the additional insured or any of the additional <br />insured's agents or "employees" other than you; and <br />4) such insurance does not apply if the additional insured is subject to motor carrier insurance requirements <br />and is not insured for hired "autos" under an "auto" liability insurance form that insures on a primary basis <br />the owners of the "autos" and their agents and "employees" while the "autos" are being used exclusively <br />in the additional insured's business and pursuant to operating rights granted to the additional insured by a <br />public authority. <br />B. The insurance afforded to such additional insured: <br />1) Applies only to the extent permitted by law; and <br />2) Will not be broader than that which you are required by a contract or agreement to provide for such <br />additional insured. <br />C. The most we will pay on behalf of the additional insured is the lesser of the amount of insurance: <br />1) That you are required by a contract or agreement to provide for such additional insured; or <br />2) That is available under the applicable Limits of Insurance shown in the Declarations. <br />All other terms, conditions and agreements remain unchanged. <br />Additional Premium <br />Company Name <br />Policy Number 72 APB 012913 <br />National Fire & Marine Insurance Company <br />Endorsement Effective 11/17/2025 12:01 AM <br />Named Insured <br />Countersigned by <br />M. BREY INC <br />(Authorized Representative) <br />(The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy .) <br />M-5887 (08/2017) 11/21/2024 <br />