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08/25/2004 10:20 909-587-2995 <br />it � <br />i <br />Sco le Insumnee Company { <br />REL�AGO DEL CILLO, INC. <br />Endorsement No. I <br />POLICYNUMBER: CLS1000567 <br />EFFECTNE:06/23/04 TO 02/14/05 <br />ANTHEM INSt1RANCE <br />VULCAN F XC <br />'SERVICE, INC. <br />PAGE 03/03 <br />S AND SURPLUS INSURANCE <br />0402s 6/24/04 <br />COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED. - OWNERS, LESSEES OR <br />CONTRACTORS <br />(WITH OPTIONAL COVERAGE'; PROVISIONS) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABTLITY COVE 1AGE PART <br />ix <br />Narde 6412crson or Organization: SCilfsDiJ <br />PITY Ol SANTA ANA COMY4 DEVELOPMENT AGENCY <br />TTN: JOI-IN MALONEY <br />20 CIVIC CENTER PLACE <br />SANTA ANA, CA 92701 <br />Who Is An Insured (Section In is amended to include as an insured the person or organization shown in the <br />Schedule, but only to the extent The additional insured is held liable for the Named Insured's negligent acts or <br />omissions arising from occurrences directly caused by, and whilein the course of the Named Insured's ongoing <br />operations performed for that additional Insured. <br />Optional Coverage Provisions applicable to the ahnve. The selected eption(s) Is designated by a mark in the box to <br />the left of the option. <br />Option A. The insurance provided by this endorsement shall be primary, but only iq the event of the Named <br />Insured's Sole negligence. <br />Option B. The insured provided by this endorsement shall be prii ary and lion contributory, but only in the <br />event of the Named tnsurad's sole negligence. <br />i <br />r <br />_ 1 �ption C. The insurance Ovid d b this endorse ent is ame d i Y � n to include any person or <br />organization that the arned Iasumd has agreed and/orf is required by contract to ueme as a^ <br />Additional into d. schedule on file with company. I <br />NO ADDITIONAL PREMIUM <br />r <br />� '• AuthorbxdRePnsentanve Date <br />