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<br />11. I <br />: ,a6/14/29a4 ,15: 9,3 <br /> <br />-"-'/ <br /> <br />11 <br /> <br />, <br /><---,,' <br /> <br />, ' <br /> <br />! ill, <br /> <br />--' <br /> <br />Ii <br />¡Iii III <br /> <br />2129864713 <br /> <br />LEGAL DEPT <br /> <br />PAGE 03/aS <br /> <br />1"OLICYNI,1:MBER: lIDO G20591365 <br /> <br />COMMERCIAL GENERAlllA8JLlTY <br /> <br />TRrs ENDORSEMENT CHANG);¡S THE POLICY. PLEASE REÁb IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES <br />OR CONTRACTORS (FORM B) <br /> <br />Thi5 endors..ment modffies Insurance provid~d under the following: <br /> <br />I, <br /> <br />. , <br /> <br />COMMERCIAL GENERAL LlA61LITY COVERAGE PART <br /> <br />¡\ <br />" <br />! <br /> <br />SCHEDULE <br /> <br />1. Name of Person Or Organization: <br /> <br />THE CITY OF SANTA ANA, rrs OFFICERS, EMPLOYEES, VOLUNTEERS AND <br />REPRESENA.!IVES <br /> <br />(If no entry "ppcars aboVe, Information required to complete this endorsement will be shown In the Declarations SI¡ <br />applicable to this endorsement.) .. <br /> <br />¡Ii <br /> <br />WHO IS AN INSURED (SeGtion II) 15 amended to Indude as an Insured the person or organ~ation 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 />CG20101185 <br /> <br />I i <br /> <br />II <br />il <br />!I <br /> <br />, . .c,) ¡.()R;vl <br />APPROVED ,,~ ", ., <br />~3& <br />._- ""., <br />'è'> ¡.,';I, Y'.:",' <br />;-\,;"-,,,'- C:r\ ""t ,,;1,'\ <br /> <br />I ¡ <br /> <br />CoPyrfght. Insurance ServlQlils Office. lno., 1984 <br /> <br />I ! <br />