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Rl'G 04 2005 4:lOPM TCP RSSOC 909..^--"~1Z45 P,2 <br />Insured: Mariners Church, Inc. and Lighthouse Learning Center <br />Policy Number: 1169-023 Commercial General Liability <br />THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY <br />ADDITIONAL INSURED-OWNERS, LESSEES OR CONTRACTORS <br />(FORM 8) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization: <br />City of Santa Ana, its officers, agents, employees and representatives <br />Re: Operations of named insured: Grant <br />(If no entry appears above, information required to complete this endorsement <br />will be shown in the Declarations as applicable to this endorsemen :.) <br />WHO IS AN INSURED (Section III is amended to include as an insured the person or <br />organization shown in the Schedule, but only with respect to liability arising <br />out of your ongoing operations performed for that insured. <br />/~ <br />~`~ <br />Signa =ure Authorized Representative <br />CG 20 10 11 93 Copyright, Insurance Services Cffice, Inc. 1992 <br />.r~:<c~~4i1> ~~s rcJ F <br />orn~r <br />-aria Si;r i>neeuv <br />