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;Iipr'02 <br />03 12:20p PRCSR <br />5714211 <br />p.7 <br />FROM <br />FAX NO. :8585190822 <br />Mar. 28 2003 01:54PM P3 <br />This Endorsement changes the Commercial Liability Policy. PLEASE read it cardwly. <br />This endorsement, effective an 02/20/03 at Standard time shown in the Policy Declarations, forme a part of policy <br />Number EOL5281394-00 issued to 0376126 Karate Do Kiai by Zurich Insurance FWIA. <br />Fndorscment Number 001 <br />This endorsement mollifies insuramtce provided for under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />ADDITIONAL INSURED - BLANKET FORM <br />WHO IS AN INSURED (Section Il) is amended to include as an insured the petson(s) or organization(s) shown in the <br />Schedule as an insured but only with respcct to liability arising out of your operations or premises owned by or mated to <br />you. <br />Name of Person or Organizatina <br />APPROVBll AS TO FORM City or Santa Ana <br />20 Civic Center, Santa Ann CA 92701 <br />City, State zip <br />La ra Sheedy <br />T)cpuly City AttorncX <br />All certificates of insurance holders you have agreed to include as an insured prior to an "occurrence" or <br />offense. <br />(8-97) <br />