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i <br />ENDORSEMENT <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />NON-OWNEDIHIRED AUTO LIABILITY <br />This endorsement, effective on 1/26/2004 forms a part of <br />(13:01 A.M. Standard Time) <br />Policy Number: 3CM4080 Certificate Number: SSA03-0018 <br />Issued To: Orndorff, Jon <br />By: Essex Insurance Company <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />COVERAGE ADDITIONAL PREMIUM <br />Coverage applies only to The City of <br />Non-Owned/Hired Auto Liability Santa Ana as limited by the specific work <br />Performed under this certificate. No coverage <br />Afforded to certificate holder <br />NON-OWNED/HIRED AUTO LIABILITY <br />The insurance provided under COVERAGE A (Section I) applies to "bodily injury" or "property damage" arising <br />out of the use of any "non-owned/hired auto" in your business by any person other than you. <br />With respect to the insurance provided by this endorsement: <br />The exclusions, under COVERAGE A (Section I), other than exclusions A, B, D, F and I are deleted and the <br />following exclusions are added: <br />"Bodily injury" <br />(a) To an "employee" of the insured arising out of and in the course of employment by the insured; or <br />(b) To the spouse, child, parent, brother or sister of that "employee" as a consequence of paragraph (a) <br />above. <br />This exclusion applies: <br />(a) Whether the insured may be liable as an employer or in any other capacity; and <br />(b) To any obligation to share damages with or repay someone else who must pay damages because of the <br />injury. <br />Page 1 of A PROVED AS TO 1-viZ <br />This exclusion does not apply to: ( 1 <br />Michael Vigliotta <br />Deputy Cry ^ rrn*nly <br />