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<br />POLICY NUMBER: FMMI009930 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <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, Clerk of the City Council, it's officers, employees, agents, volunteers <br />and representatives <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the Dec]arations as app]icable to this <br />endorsement. ) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insmed the person or organization shown in the Schedule, but only <br />with respect to liability arising out of your work for tltat insured by or for you. <br /> <br />CG20 10 II 85 <br /> <br />Copyrigh~ Insmance SelVices Office, ]nc., ] 984 <br /> <br />A,-.,-") <br />Yt <br /> <br />TO FORM <br /> <br />'- /~<"-(//'.'- <br />/ ,j,) (f -"_ <br /> <br />u v <br /> <br />AS:),>;I:: j "',' /\udrney <br /> <br />