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Aug 22 2008 8:08AM <br />COMMUh1ITYitSENIORSERV 7148167397 <br />ADDITIONAL INSURED ENDORSEMENT <br />Insurance Company . Philadelphia Indemnity Insurance Company <br />This endorsement modI iee euCh IrOurance ae Is afforded by the provisions of Policy <br /># PHpK325277 W&thlgkrthe fdlowbng: <br />1 The City of Santa Ana, 20 Civic Canter Plana, Santa Ana, COIKOtrle <br />92701: lis officers, employees, agents and volunteers are named as additional Inured* <br />(,additional insureds*) wllhns by do liability and <br />Of the olan"nanwed ►e1 sub <br />arising *am the <br />operations and uses p9rionned <br />2. With respect 10 Chita adslr►g out of the operations and used petfomted by <br />or on behaK 91 Vw namedinsured, Butch ffo <br />ch Insurance as Is arded by this PoODY Is <br />primary and Is not sxlditionel to or oattribt ding with any otite► Insuranoe carried by or tot <br />the benefit of the addRional Msu%A,r• <br />8. This inaurance apPllee aeparabs►y to each Insured against itsof whom dein Is <br />made or suit is brought except wldl respect to the compan�e limits Of limbgily. The <br />Induaion of mer person or orgunlx�►tlat se on Insured *hall not affect any right which <br />such person or organization would t►9ve as a cWmwd if not so Included. <br />4. With urance <br />not <br />to <br />canceled, or "Wally reduced In OI r,7e or II" is 6=9Pt silerct to the additional Instwedso this sthiAY Com? daYl s wane, <br />notice has been given 10 the GAY of Sella Ana, 20 CivIO Cerner Firma, Santa Ana, <br />Califamia 92701. <br />(Completion0 the following, Inciuding eountersipnsture, is required tc make this <br />endorsement effective.) <br />Effective 7/1/2008 _, tide endorsement form as a part d <br />Policy # PHPK325277 _ _ <br />Imed t0 Community scniorSery DBA: Feedback Foundation <br />Named Inured <br />r'� <br />' v1�n.ertr vl- <br />Counterttgned by /A -P-4 ; <<�A <br />Authorind epresen Ove <br />F.3 <br />