Laserfiche WebLink
<br />I",.. <br /> <br />-' <br /> <br />POLICY NUMBER: GL 2095788109 A/S COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <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: <br /> <br />CITY OF SANTA ANA, ITS OFFICERS AND EMPLOYEES <br /> <br />(if no entry appears above, information required to complete this <br />endorsement will be shown in the Declarations as applicable to this <br />endorsement. ) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured <br />the person or organization shown in the Schedule, but only with <br />respect to liability arising out of "your work" for that insured by <br />or for you. <br /> <br />PB #11972 <br /> <br />o~ <br />.~~ <br />~~ <br />~ <br />~'(,.~ ~f. ~'l <br />(j~~O f} (. .:; Cl (..~,~~ <br />'" O';o."~0('.1 <br />o '.~\. ^) <br />.~'(.tj '/ <br /> <br />~ 0~ <br /> <br /> <br />CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 <br /> <br />Serial #: 506062 <br /> <br />Page 2 <br />