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A 12/1/2004 00:07 9492639233 ACI INS AGENCY PAGE 02 <br />POLICY NUMBER: TBA COMMERCIAL GENERAL LiABTLTTY CG 20 10 1.0 93 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS (.FORM B) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Pcrson or Organization: THE CITY OF SANTA ANA <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CALIFORNIA 92701; <br />ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS <br />AND REPRESENTATIVES ARE NAMED AS <br />ADDITIONAL INSUREDS WITH REGARD TO LIABILITY <br />AND DEFENSE OF SUITS ARISING FROM THE <br />OPERATIONS AND USES PERFORMED BY OR ON BEHALF <br />Ca)AI:130►/ 613111Ii IM113113 <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization <br />shown in the Schedule, but only with respect to liability arising out of your ongoing operations performed <br />for that insured. <br />Such insurance as is afforded by this policy is primary and is not additional to or contributing <br />with any other insurance carried by or for the benefit of the additional insureds. <br />212- <br />CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992 Page I of 1 <br />