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<br />GR..LAG!-[R !-[~L TI-().RE <br /> <br />Fax:713-365-6488 <br />. <br /> <br />Nov 6 20~ 16;14 <br /> <br />P.04 <br /> <br />. <br /> <br />COMMERCIAl GENERAl LlABltJTY <br /> <br />rOLlCV NUMBER: 61 UEN UV5523 <br />CHANGE NUMB2R., CO 1 <br /> <br />THIS ENDORSEMENT CHANGES THE pOLICY. PLEASE READ IT CARERJU,V. <br /> <br />ADDITIONAL INSURED. DESIGNATED PERSON OR <br />ORGANIZATION <br /> <br />TIlls IIIldOlSlll'l\ll1\l modifies insurallOll provid&d under the fdloWilltJ; <br /> <br />II> <br />~ COMMERCIAL GENERAl LIABIUTY coVERAGE PART <br />'" <br />'" <br /> <br />. <br />o <br />... <br />~ SCHEDULE <br />'" <br />on <br />In <br />~ N.-...~orOl'P'~: <br />.... <br />'" <br />.. <br />o City of Santa Ana, it'. officers, agents, employees. and volunteers <br />'" <br />o <br />o <br />. <br /> <br />=" <br />= <br /> <br />:: <br />== <br />"". <br />is <br />;; <br />.- <br />== <br />-= <br /> <br />!:: <br />~ <br />~ <br />.... <br />:::;:;:: <br />- <br />- <br />- <br />- <br />- <br />- <br />..., <br />- <br /> <br />... <br />!- <br />1!5 <br />- <br />- <br />...... <br /> <br /> <br />~ <br /> <br />- <br />= <br /> <br />(If no ontry appears aboVll, inlormatiDn mqulf9d 10 complete lhis endon;emellt IMII be shawn in lhe DedBl'alions as <br />applicabllllo \IIis lI/IlWsemenL) <br /> <br />WHO IS AN INSURED (Sar;Uon II) is amll\d8C11o Inoludll- an insurllCl 11\8 pSI'SClf1 or organization shawn in !he Sc:l\8duls <br />as an insured but only with raspeel 10 liabilily arising out of YOllr oparaliolls or premise& owroed by Cl' r8llted to yoU. <br /> <br />~a ,rlJ/ ~;~: <br />rc::::1'~7 .,.,.,--..---- <br /> <br />CG20261185 <br /> <br />COpYrtgt1l, Insurance lOarvic&5 Otlioe..lnc., 19&4 <br />