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05/17,2005 13:49 FAX SPRCIALTY_Rt1W—SERVICES (: 003/003 <br />CG YO at <br />(Ed. 11 85) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED--DESIjGNATED PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the faIIowing:poIiCOPAC5373& <br />COMMRCIAL.GENERAL LIABILITY COVERAGE PART for 'MERCY HOUSE, P,O. BOX 1905, <br />Santa Ana, CA, 92702, <br />SCHEDULE <br />Name of Person or Organization. The City of. Santa Ana, its officials, employees, <br />representatives, and volunteers are hereby named as Additional Insureds as <br />respects the operations of or on behalf of Mercy House Transitional Living <br />Center,.performed under contract -with -The City of Santa Ana, <br />(If no entry appears above, information required to Complete this endorsement <br />will be shown in.the Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section 11) is amended to include as an insured the person <br />or organization shown in the Schedule as an insured but only with respect to <br />liability arising out of your operations or premises owned by or rented to <br />you. — , <br />APPROVED A 'TQJI ''ti R ;�,r 17 f !: y <br />La `r`� Sl-.eedy -- <br />Assistant City Attorney <br />Copyright, Insurance Services Office, Inc., 1984 <br />CG 20 26 (Received TlmefMeY.l7• 11:42AMIPage 1 of 1) <br />