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<br />tel 10/22/2004 <br /> <br />Time: 12:04 PM To: City Santa Ana @ 17146476515 <br /> <br />1-510-452-2193 <br /> <br />Paqe: 003-003 <br /> <br />. <br />~ <br /> <br />Policy Number: <br /> <br />BK01406348 <br /> <br />OwnersÒLessees or Contractors (Form B) <br />ADDITI NAL INSURED <br /> <br />Change(s) Effective: 10/22/04 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT <br />CAREFULLY. This endorsement modifies insurance policy under the following: <br /> <br />LIABILITY COVERAGE PART: <br /> <br />Schedule <br /> <br />Name of Person or Organization: <br /> <br />The City of Santa Ana** <br />Attn: Mario Ghizzi <br />20 Civic Center Plaza, M-11 <br />Santa Ana, CA 92702 <br /> <br />SECTION II - WHO IS AN INSURED is amended to include as an insured the <br />person or organization shown in the Schedule, but only with respect to liability <br />arising out of "your work" for that insured by or for you. <br /> <br />City of Santa Ana, its employees, officers, volunteers <br /> <br />PRIMARY INSURANCE: <br />IT IS UNDERSTOOD AND AGREED THAT THIS INSURANCE IS PRIMARY <br />AND ANY OTHER INSURANCE MAINTAINED BY THE ADDITIONAL INSURED <br />SHALL BE EXCESS ONLY AND NOT CONTRIBUTING WITH THIS <br />INSURANCE. <br /> <br />~J"L <br /> <br />CUBF 22 40 03 95 <br /> <br />