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<br />. <br /> <br />. <br /> <br />POLICY NUMBER: 57CESOA1661 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES or <br />CONTRACTORS (FORM B) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br />City of Santa Ana <br />Attn: Tonia Zerba <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule, but only with respect to liability arising out of "your work" for that insured by or for you, <br /> <br />Additional Insured Continued: <br /> <br />its officers, agents, and employees <br /> <br />v (". <br />:-,. '..~ <br /> <br />.-./ <br /> <br />, ',¡., <br />~. >J ' j f ,-. <br /> <br />-_. <br /> <br />~.3f.J._... <br /> <br />'1 ~,."r'- ~-'1':r~\ L;~~c!._ly <br />"""~~"'~~"~ ,..J <br /> <br />:t..S;;;:"S~<l-3.[ (~~IY ~\~"':-;r-:.(''j <br /> <br />CG 20 10 11 85 <br />