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POLICY NUMBER: N9BP752992 <br />BUSINESSOWNERS <br />BP 04 48 01 06 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - DESIGNATED PERSON <br />OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE <br />Name Of Additional Insured Persons Or Or anization s : <br />City Of Santa Ana, It's Officers, Agents, Representatives And Employee <br />Risk Management Division <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />The following is added to Paragraph C. Who Is An <br />Insured in Section II — Liability: <br />3. Any person(s) or organization(s) shown in the <br />Schedule is also an additional insured, but only <br />with respect to liability for "bodily injury", "property <br />damage" or "personal and advertising injury' <br />caused, in whole or in part, by your acts or omis- <br />sions or the acts or omissions of those acting on <br />your behalf in the performance of your ongoing <br />operations or in connection with your premises <br />owned by or rented to you. <br />RIAMowgnnadDIMimt <br />o REVIE &APPRmm BY: <br />A-.4 A...44 <br />® Risk Managemen[SpedBist <br />01 <br />BP 04 48 01 06 © ISO Properties, Inc., 2004 Page 1 of 1 0 <br />