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APR-21-20C4 ll:0T FROM -ALL CAL INS 9157840158 T-830 P.0021002 F-T30 <br />1 <br />"Zt DO E NT <br />'POIICYINR MBER: ,(__ �+` r/ "D.��•2 AA__ <br />#INSIMED COMPANY NAME: C �� <br />THIS ENDOIdXIIAENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED — DESIGNATED PERSON or <br />ORGANIZATION <br />This endorsewent modifies insurance provided under the following: <br />COMMERCIAL GENE". LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization: <br />City of Santa Ana <br />entry appears above, information required to complete this each Wm=t will be <br />l in the Declarations as applicable to this endatsemew.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or <br />organization shown in the Schedule, but only with rospeet to liability arising out of your <br />operations or premiss owned by or rallied to you. <br />IT IS AGREED TETAT ANY INSURANCE MAINTAINED BY THE CITY OF <br />SANTA ANA <br />SHALL APPLY IN FXCeW Oil, ANU NOT CONTRIBUTE WITH. TNSURANCN <br />PROVIDED BY THIS POLICY, <br />Agent's Signature: <br />JpE �SfaYLQ <br />Cc 201011 Is <br />(21S)CSAMPLE-Additional inwred wlth Pr"#r^On•CoibibWn$ Lmliuw,ye Added <br />