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<br />,POLICY NUMBER: 680-4\-;105-A <br /> <br />...,; COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CARE FULL y, <br /> <br />ADDITIONAL INSURED----DESIGNATED PERSON OR <br />ORGANIZATION <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, M.25 <br />COMMUNITY DEVELOPMENT AGENCY <br />PO BOX 2988 M-25 <br />SANTA ANA, CA 92702 <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or <br />rented to you. <br /> <br />CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES AND VOLUNTEERS ARE NAMED AS <br />ADDITIONAL INSURED AS RESPECTS THEIR INTEREST IN CONNECTION WITH THE NAMED INSURED, <br /> <br />AhROVED AS TO FORM <br /> <br />/ .. o,tf <br />Lura'Sheedy - <br />Deputy City Attorney <br /> <br /> <br />Copyright, Insurance Services Office, inc. 1984 <br />