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<br />NAUTILUS INSURANCE COMPANY <br /> <br />POLICY NUMBER: BN697479 <br /> <br />LIABILITY ENDORSEMENT <br /> <br />THIS Ef\jCORSEMENT CHN-JGES THE POLICY PLEASE READ IT Cf-\REFULL Y <br /> <br />ADDITIONAL INSURED ENDORSEMENT <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: Premium $ 150.00 <br />City of Santa Ana <br />20 Civic Center Plaza - Ross Annex (M-) <br />Santa Ana. CA 92701 <br /> <br />VVHO IS AN INSURED (Section II) is amended to include as an insured the person or organization ShOMl in <br />the Schedule and only for liability arising out of your negligence and only for occurrences or coverages not <br />otherwise excluded in the policy to which this endorsement applies. <br /> <br />Your policy is primary in the event of an occurrence caused by your sole negligence as respects the job <br />described below: (MUST BE COMPLETED) <br /> <br />Job Description: <br /> <br />All other Terms and Conditions of this Insurance remain unchanged. <br /> <br />S 114(04/97) <br /> <br />