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INSURED: Human Options <br />POLICY NUMBER: PHPK094958 <br />EFFECTIVE DATE: 09/23/04 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br />ADDITIONAL INSURED -DESIGNATED PERSON OR ORGANIZATION <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, employees, agents, volunteers & representatives <br />(If no entry appears above, information required to complete this endorsement will be shown in <br />the Declarations as applicable to this endorsement) <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 out of <br />your operations or premises owned by or rented to you. <br />Z�L <br />CG 20 26 11 85 <br />PUR OCTOI'04 pti 3:24 <br />