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<br />POLICY NUMBER: ACP7840784533 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />TillS ENDORSEMENT ClIAJ.'!GES THE POLICY. PLEASE READ IT CAREFULL Y. <br /> <br />ADDITIONAL INSURED - DESIGNATED PERSON OR <br />ORGANIZATION <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br /> <br />SCHEDULE <br /> <br />Name of person or Organization: <br /> <br />The City of Santa Ana, its officers, employees, agents, volunteers and representative <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />(If no entry appears above, information required to complete this endorsement will be <br />shown in the Declarations as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED(Section II) is amended to include as an insured the person or <br />organization shown in the Schedule as an insured but only with respect to liability arising <br />out of your operations or premises owned by or rented to you. <br /> <br />APPROVED AS TO FO"", <br /> <br />ii't2 :2k <br />LaUJ;} .,Litt Sheedy <br />Assisldlll City Attorne\' <br /> <br />CG 20 26 11 85 <br />1 of 1 <br /> <br />Copyright, Insurance Siervices Office, Inc., 1984 <br /> <br />Page <br />