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0~x11/2003 17:04 BACCARELLA INSURANCE a 17145652693 <br /> <br />POLICY NUMBER: 25370074S0 COMMERCIAl. 0ENERAL LIABILITY <br />C. B. Glenn Tile Company, I~c. CG 20 10 03 97 <br /> <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> ORGANIZATION <br /> <br />This endorsemenl modifies Insurance pr,',vlded under Ihs following: <br /> <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br /> SCHEDULE <br /> <br /> Name of Per, on or Organization: <br />ICIty of Santa Aha Is officers, agents & employees , <br /> <br />(If no entry appears above, information required to complete this endorser~ent will be show~ in the Decla~al]ons as <br />applicable lo this endorsement.) <br /> <br />Who la An Inl~lred (ltactlon I)) la amended to include as an Insured tile person1 or erganizalion shown In ~e <br />Schedule, bu~ only with respect to liability arising out of your ongoing operations performed for Ihat Insured. <br /> <br />Job: The Depot et Saute Aha, 1000 E. Santa Aris Blvd., Santa Aha, CA <br /> <br />CG ~g t0 03 07 Copyright, Insurance Sa~lcss Office, Inc., lgg6 Pag~ '1 of '1 E~ <br /> <br /> <br />