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O T � <br />9/27/2007 12:43 PM PAGE 2/002 Fax Server <br />�C'_ CvVAIBER: PHPK258028 COMMERCIAL GENERAL LIABILITY <br />Policy Pericd 09101101 to 091/01/08 CG 2021;0704 <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 following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) Or Organization(s) —A <br />City of Santa Ana Parks, Recreation 5 Community Services Agency <br />At.l.n: Carla Mack T1i.)mpk i ns <br />?.C. Box 19 68 M -23 <br />Santa Ana, CA 92102 <br />City of Santa Ana, its officers,agents, employees, - eprasentatic-Fs and velunteer< are named <br />as Additional Insureds for General Liability per enclo.sement Form 4CG20260704 attached as <br />e operations of the named insured. Such insurance shall --e primary and non <br />= antributory. <br />i Information reouired to complete this Schedule, if not shown above, will be shown in the Declarations. !� <br />Section ill — Who Is An Insured is amended to in- <br />clude as an additional insured the person(s) or organi- <br />zation(s) shown in the Schedule, but only with respect <br />to !iability for "bodily injury ", "property damage" or <br />"personal and advertising injury" caused, in whole or <br />in part, by your acts or omissions or the acts or omis- <br />sions of those acting on your behalf: <br />A. in the performance of your ongoing operations; or <br />S. 'n connection with your premises owned by or <br />rented to you. <br />CG 20 26 07 04 <br />© ISO Properties, Inc., 2004 <br />Pate 1 of 1 ❑ <br />