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<br />Philadelphia Indemnity Insurance Company <br /> <br />Additional Insured Schedule <br /> <br />Policy Number: PHPK141731 <br /> <br />Additional Insured <br /> <br />CIlY OF CYPRESS, CYPRESS RECREATION PARK <br />DISTRICT <br />5275 ORANGE AVE. <br />CYPRESS, CA 90620 <br />CG2026 - CA - Loe # 1 <br /> <br />Additional Insured <br /> <br />CIlY OF SANTA ANA <br />COMMUNIlY DEVELOPMENT AGENCY <br />M-25 <br />P. O. BOX 1988 <br />SANTA ANA, CA 92702-1988 <br />CG2026 - CA - Loe # 1 <br /> <br /> <br /> <br />~ .., /:!:::::::.: <br />~~u:t- <br /> <br />._~,' .,~.. ..L (:: <br />~.~.---- . ,"."" l7.'. (;',!,". t.. L-,; ",:, <br /> <br />.".," J~1'.d'~i~ C:~tV p'l,nc<'" ,'" <br /> <br />Page 1 of 1 <br />