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FROM : FAX NO. : Aug. 18 2004 07:51RM P4 <br />Jul 28 04 OIt58p p.15 <br />POLICY NUMBER: PHPKCK4641 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY PLEASE READ THIS CAREFULLY <br />ADDITIONAL INSURED PRIMARY COVERAGE <br />This endorsement modifies Insurance provided under the Following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />This insurance is primary for the person or organization shown in the schedule, but only with respect to liability arising out of your <br />work or that insured by or for you. Otter Insurance effdtrled to that Insured will apply as excess and not contribute as primary to the <br />insurance aftdod by this endorsement <br />All other endorsement provisions. conditions and exclusions of this insurance shall remain unchanged and apply to the additional <br />Insured and described below. <br />SCHEDULE <br />ADDITIONAL INSURED <br />CITY OF SANTA ANA <br />COMMUNITY DEVELOPMENT AGENCY M-25 <br />P.O. BOX 1988 <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 82702.1995 <br />NAMED INSURED COUNCIL ON AGING OF ORANGE COUNTY <br />971 E. 4TH ST. SURE 200 <br />SANTA ANA CA 927053917 <br />De hire ",rj;•, 6F— , <br />