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APR-21-2004 11:07 FROM -ALL CAL INS 9167840158 T-830 P.002/002 F-730 <br />*POLICY NUNIBER: � -A <br />"INSURED COMPANY NAME: <br />THIS ENDORSXMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED <br />— DESIGNATED <br />ES ORGANIZATION <br />TED PERSON or <br />This eadorsenient modifies insuranaa ptovidad under the following: <br />COMMERCIAL GENERAL. LIABILTCY COVERAGE PART <br />SCHEDULE � 6--Z00-6 ' <br />3 2s�zooS� <br />Name of Parson or Organization: <br />� r <br />City of Santa Ana an <br />above, information required to oomplcta this eodnrsement will be <br />shown in the Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (5oction» is amended to include as an insured the person or <br />ocgWzadon shown in the Schedule, but only with respect to liability arising out of your <br />operations or premises own0d by ar rented to you. <br />IT IS AGRE6.D TRAT ANY INSURANCE MAINTAINED BY THE CITY OF <br />SANTA ANA <br />SHAXA, APPLY IN RxCWOV,AND NOT CONTRIBU'M WITH. INSURANCE <br />PROVIDED I3Y THIS POLICY. <br />Agent's Si$nat"re:. <br />�400 israrLa <br />cc 2010 rt ss <br />(21 t)C SAMPLE —Adds ianol tnwred with Primeryl pg.Contrihun" LsnJuje Added <br />