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POLICY NUMBER: EOL9012327-01 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 <br />SCHEDULE <br />Name of Person or Organization; CITY OF SANTA ANA <br />PARKS, RECREATION, & COMMUNITY SERVICES AGENCY <br />888 W. SANTA ANA BLVD, SUITE 200 <br />PO BOX 1988 M-23 <br />SANTA ANA, CA 92702 <br />(If no entry appears above. information required to complete this endorsement will be shown in the <br />Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization <br />shown in the Schedule, but only with respect to liability arising out of "your work' for that insured by <br />or for you <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES, REPRESENTATIVES, AND VOLUNTEERS <br />ARE NAMED AS ADDITIONAL INSURED ONLY AS THEIR INTERESTS MAY APPEAR. <br />CG 20 10 11 85 Copyright. Insurance Services Office, Inc., 1984 <br />Certificate # 30781 <br />�a_13 <br />