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JJN.25.2003 2:49PM VAN BUERDEN INSURANCE N0.073 P. 3 <br />POLICY NUMBER: NAC1415007165 COMMERCIAL GENERAL LIABILITY <br />Golden Bch Products, Inc. co 20 10 10 93 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br />This endorsement modits insurance provided under the blowing: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Nam of Person or OrprAcation: <br />City of Santa Ana <br />Its offices, employees, agents and representatives <br />20 Civic Center Plaza, Room 429 <br />Santa Ana, CA 92702 <br />(If no entry appears above, information required to complete this endorsement VAN be shown In the <br />Declarations as applicable to this endorsement) <br />WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organiretion shown In <br />the Schedule, but only with respect to liability arising out of your ongoing operations performed for that <br />insured. <br />It is agreed such insurance as is afforded by this policy for the benefit of the additional <br />insured(s) shown in the endorsement, shall be primary insurance. Any other insurance <br />maintained by the additional Insureds) shall be excess and non-contributory not only as <br />respect to any claim, loss or liability arising out of the operations of the named insured, <br />and only if such a claim, loss or liability is determined to be solely the negligence or <br />responsibNity of the named insured. <br />CG 20 10 10 93 Copyright, Insurance Services 2ffm, Inc.. 1992 <br />0 <br />