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<br />~....::;.;A;r: 3iJ1/10J .6IJ"''''' ",.,,\'S' ",,~"'::O/"';):::l: r....:._L~ :~S ,;'J:;S <br /> <br />"A~: :. <br /> <br />POLICY NUMBER: GLAlOO 390 6 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, lESSEESS or <br />CONTRACTORS [FORM B) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />City of Santa Ana <br />its officers, agents and <br />employees <br />220 South Daisy <br />Santa Ana CA 92703 <br /> <br />{if no entry appears above, information roquired to complete this endorsement wil be shown in the Declarations <br />as applicable 10 Ihis endorsement.} <br /> <br />WHO IS AN INSURED (Section 11) is amended to include as an insurod the person or organization shown in <br />lhe Schedule, bul only with respect 10 liability arising oul 01 "your work" for Ihallnsured by or for you. <br /> <br />.* Supplemental Name ** Harper & Associates Engineering, <br />Inc _ <br /> <br />CG20101185 <br />