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<br />5 <br />~ <br />~ <br />le3 <br />m <br />fii!!!l! <br />- <br />~ <br />~ <br />~~ <br />~ <br />11 <br /> <br />~ <br />~ <br />-=-~ <br /> <br />01-14-C1 <br /> <br />11:!TAM FROM-NHver AHociQtes <br /> <br />4 <br />" <br />... 'ff <br />o <br /> <br />. <br /> <br />:.; <br />0' <br />" <br /> <br />PolicV Number. BK00749453 <br />State Or Political Subdivisions - Permits <br />AODITIONAL IIISUREIl <br /> <br />o <br />o <br /> <br />t- <br /> <br />OlE zgHOIO <br /> <br />T-l41 P.C03IC03 F-492 <br /> <br />~ <br /> <br />THIS ENIlORSEMENf OiANIiES THE POLICY. PLEASE READ IT REfULL Y, <br />This endorser:lent modifies lnSJranCe provided under 1h~ fot/awing' <br /> <br />'" <br /> <br />lIA8illTY COVERAGE PART <br /> <br />. <br /> <br />'" <br />'" <br />'" <br />.., State 0' Political Subdivision: <br />'" <br />" <br />'" <br />~ City of Santa Ana <br />g 20 Civic Center Plaza <br />" <br />'" Santa ft.na, CA 92702 <br />N <br />o <br />o <br />o <br />'" <br />. <br /> <br />Sch dule <br /> <br />SECTiON II . WHO is AN INSURED" amende" to indude as an <br />insured anv state or pOlitical subdivi,ion shown in the Schedule. <br />s~bject to the following pro'lisioilS: <br /> <br />1. This insurance spplies orl!Y with respecr to operaticns <br />pertormed by you or on your hehalf for which the state {lr <br />political subdivi:;ion has issued a permit. <br /> <br />CVS:=: Z2 eo 03 95 <br /> <br />2,. This insurance does not apply 10: <br /> <br />a. 'Bodily in:u"l: "proporty damage: "personal iojur!"or <br />'ad;ercising inju,," arising out of operalions performed <br />lor the state or municipality: or <br /> <br />b. "Sadilv iniu",' or "property damag' included within tho <br />.pn)dlK:(s-completed Qperatiofl,s hazard. ~ <br /> <br />APPROVED AS 1'0 fOlZlVJ <br /> <br /> <br />Pafii'10f1 <br />