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ENDORSEMENT <br />*POLICY NUMBER: �Z9& r(92 � /,�- <br />*INSURED COMPANY NAME: <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - DESIGNATED PERSON or ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization: <br />City of Santa Ana and its Officers, Agents, Employees and Volunteers are <br />named as additional insured as respects their interest in connection with the <br />named insured. <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule, but only with respect to liability arising out of your operations or premises owned by or rented to you. <br />IT IS AGREED THAT ANY INSURANCE MAINTAINED BY THE CITY OF SANTA ANA SHALL <br />APPLY IN EXCESS OF, AND NOT CONTRIBUTE WITH, INSURANCE PROVIDED BY THIS <br />POLICY. <br />Agent's Signature: <br />Joe <br />CG 2010 11 85 <br />(218)C SAMPLE - Additional Insured with Primarv/Non-Contributing Language Added <br />J,„ °•ttor�e> <br />i �.95t2�•'• .� <br />�2 <br />- _ <br />