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<br />,25/1~<2005 13:49 FAX <br /> <br />SPECIALTY....BUllAN_SERVI CES <br /> <br />Tal 003/003 <br /> <br />..--"', <br /> <br />eG 20 :t. <br />(Ed. 11 851 <br /> <br />, <br /> <br />THIS ENDORSeMENT CHANGES THE POLICY. PLEASE READ ,IT CAREFULLY. <br /> <br />ArlDIT I(WM, INIlIIED--DES I CIlIATED PEUON OR ORGAN I ZA TrCIN <br /> <br />Thia endor.ement modi fie. inauranoe provided under the following: POliCy#PAC537388 <br /> <br />CONMeI'lCIAL,GENEPlAL LIABILITY COVERAGE PART fo('MERCY HOUSE, P.O. Box 1905, <br />Santa An~, CA, 92702. <br /> <br />SCHEDULE <br />Heme of Person or Organization: The City of Santa Ana, its officials, elTlPloyees, <br />rep resentati ves, and volunteers are herebY named as Add i tiona 1 I nsu reds as <br />respects the operations of or on behalf of Mercy House Transitional Living <br />Center, ,performed undercontract'WHh. The Ci ty of Santa Ana. <br /> <br />II f no entry appa.ra above,' information (.qul red to complete this endoraement <br />wi II be shown In ,the Oeel.rafions IS .ppl iceble to this sndors..ment.) <br /> <br />WHO IS AN INSURED' (Section III is amended to include 'IS In Insured tha parson <br />or organization shown in the Sohedule as an insured but only with reapect to <br />I labll ity Irising out o,f your operations or premises owned by or rentad to <br />you. <br /> <br />APPROVED ~liWFrilEORM3"O Pti':::;' <br /> <br />, ~~' ~/h <br /> <br />LIl fa Stitt Sheedy <br />Assistant City Attorney <br /> <br />Copyright, Insurance Services Office, Ine.. 1984 <br />CG 20 26 {Received Time FMaY, 17. 11 :42AM(Pag" I of II <br />