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Philadelphia Indemnity Insurance Company <br />Additional Insured Schedule <br />Policy Number: PHPK196567 <br />Additional Insured <br />CITY OF CYPRESS, CYPRESS RECREATION PARK <br />DISTRICT <br />5275 ORANGE AVE. <br />CYPRESS, CA 90620 <br />CG2026 - CA -Loc #1 <br />CG2026 - CA -Loc #1 <br />Additional Insured <br />CITY OF SANTA ANA <br />COMMUNITY DEVELOPMENT AGENCY <br />M-25 <br />P. O. BOX 1988 <br />SANTA ANA, CA 92702-1988 <br />CG2026 - CA -Loc #1 <br />CG2026 - CA -Loc #1 <br />VED ~ T~ Fob <br />pppRQ i <br />~( K <br />1,lSp' E•c'T Attorney <br />psststert Gtity <br />~~~~~ <br />~. <br />Page 1 of 1 <br />