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MAY.19.2009 3:14PM VAN BUERDEN INSURANCE <br />N0, 294 P. 3 <br />POLICY NUMBER: NAG141508147 COMNlr=RC1AL GENHZAL LIABILITY <br />Golden Bell Products. lnC. 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 modifies insurance provided under the fol"ng: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization: <br />City of Santa Ana <br />Its officers, employees. agents, and representatives <br />20 Civic Center Pima, Room 429 <br />Santa Ana, CA 92742 <br />(If no entry appears above, information required to complete this endorsement will 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 of organization 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 time benefit of the additlenel <br />insured(s) shown in the endorsement, shall be primary Insurance. Any other insurance <br />maintained by the additional Insured(s) shall be exoess 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 N such a claim, loss or liability is determined to be solely the negligence or <br />responsibility of the named insured. <br />GG 20 10 10 93 copyright, insurance Services O fim, lnc.,1992 Q <br />