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<br />City of Santa Ana <br />Certificate issued to City of Santa Ana' <br />Owen Dunn Insuranc. Serv;ces <br />06/17/2004 <br />20 26 11 85 COMMERCIAL GENERAL LIABILITY <br />\ . .~ED INSURED: Cooperative Personnel Serv; ces <br />FOllCY NUMBER: 3MG70480510 <br />INSUR~NCE CO~PANY: I American Manuf. Mutual Ins Co <br />EFFECTIVE DATE: 07/01/2004 <br /> <br />06/16/20001 <br /> <br />This endorse~ent changes the policy. <br />I <br /> <br />Please read it carefully. <br /> <br />ADDITIONAL INSURED--DESIG~ATED PERSON OR <br />ORGANIZATION <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GE~ERAL LIABILITY COVERAGE PART. <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />The Community Redevelopment ~gency of the City of Santa Ana, and the City of Santa Ana, their <br />respective officers, employees. agents, volunteers and representatives. <br /> <br />, ? no entry appears above, information required to complete this endorsement ~11 be shown in the <br />'Dêclarations as applicable to this endorsement.) <br /> <br />WHO IS AN I~SURED (Section II) is amended to incl~de as an insured the person or organization shown in <br />the Schedule as an insured but only with respect to liabi1ity arising out of your operations or premises <br />owned by or rented to you. <br /> <br />CG 20 26 11 85 <br /> <br />Copyright, Insurance Services Office. Inc., 1984 <br /> <br />06/17/2D04 <br />CG D2 48 10 02 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />Customer Name: Cooperative Personnel Services <br />Insurance Car~ier: TRAVELERS <br />Policy Number: 6607704A197: <br />Policy Period: 07/01/2003 to 07101(2004 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. <br /> <br />PLEASE REAO IT CAREFULLY. <br /> <br />BLANKET ADDITIONAL INSURED <br />(CONTRACTORS OPERATIONS) <br /> <br />~ERCIAL GENERAL lIABILITY COVERAGE PART <br />L~~ER(IAL GENERAL LIABILITY - CONTRACTORS COVERACE PART <br /> <br />~s/J <br />