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To~~ Clty of Santa Ana <br />Cathleen Forcucci Dance <br />Academy, Fullerton <br />POLICY NUMBER: PFSO42823782 <br />4123!2007 <br />CONTAERCIAL GENERAL LIABILITY <br />CG 2fl 26 W 00. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -DESIGNATED <br />PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the folbwing: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name OF Additional Insured Person(s) CK Q' nization151 <br />Informatan r used to lets this Schedule, rf not shaven above, will 6e shown in the Declarations. <br />Section II Who Is An Insured is amended to in- <br />clude as an additional insured the pasonls) or or- <br />ganizationlsl shown in the Schedule, but only with <br />respect to liability fa 'bodily injury'", "property dam- <br />age" or "personal and advertising injury" caused, in <br />wf>vle tr in pat, by your acts or omissions or the acts <br />or omissions d those acting on yoir behalf: <br />A In the performance of your ongoing operations: or <br />B. In connection with your premises awned by a <br />rented to you. <br />Fxom: dennifex Foxmaneck 9-Z3-117 11:30am p. 9 of 9 <br />~~- r -- <br />Laura SLtt 5~;...e~y <br />A ssrsta ut Ciiy Atior :ey <br />CG 20 2B 07 04 Copyright, ISO Properties, Inc . 2004 Page 1 of 1 ~ <br />