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POLICY NUMBER: GL0837663209 <br />COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization: The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, <br />California 92701; its officers, employees, agents,volunteers and representatives, with regard to <br />liability and defense of suits arising from the operations and uses performed by or on behalf of <br />the name insured. <br />(if no entry appears above, information required to complete this endorsement will be shown in <br />the Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section 11) is amended to include as an insured the person or <br />organization shown in the Schedule, but only with respect to liability arising out of "your work" <br />for that insured by or for you. <br />APPROVED AS TO FORM <br />Laura Slat Sheedy <br />,a,5tntlf. C ai , Attorney <br />CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 994 <br />