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<br />POLICY NUMBER: 76A2GL000001-01 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED-OWNERS, LESSEES OR <br /> <br />CONTRACTORS (Form B) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization; <br /> <br />City of Santa Ana and its officers, agents, employees <br />and volunteers are named as additional insured as <br />respect their interest in connection with the named <br />insured. <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization <br />shown in the Schedule, but only with respect to liability arising out of "your work' for that insured by or <br />for you <br /> <br />It is agreed that any insurance maintained by the City of Santa Ana shall apply in excess of, <br />and not contribute with, insurance provided by this policy. <br /> <br />':'_0 1,.3 TO FORM <br /> <br />~2/~ <br /> <br />.- -- .-" -,.. --- '-. ,- _.._---~-: <br />,_..;.~:~-.:-~ ..;~~:~. S~...::,tCj1 <br /> <br />."... _""::;"[j' ALc;--;ey <br /> <br />CG 20 10 11 85 <br /> <br />Copyright. Insurance Services Office, Inc., 1984 <br /> <br />Page 1 of 1 <br /> <br />