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POLICY NUMBER: BA68191.639 <br />Johnson-Frank & Associates, Inc. <br />COMMERCIAL AUTO <br />ISSUE DATE: 11/30/2009 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply <br />unless modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An <br />Insured Provision of the Coverage Form. This endorsement does not alter coverage provided in the <br />Coverage Form. <br />SCHEDULE <br />NAME OF PERSON(S) OR ORGANIZATION(S): <br />City of Santa Ana, Its Officers, <br />Employees, and Representatives <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to the end orsement.) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to <br />the extent that person or organization qualifies as an "insured" under the Who Is An Insured <br />Provision contained in Section II of the Coverage Form. <br />APPRO V :. , 1'0 P'OR M <br />Laura Stitt Sheedy <br />Ass ;taut City Attorney <br />CA 20 48 02 99 <br />Copyright, Insurance Services Office, Inc., 1998 <br />Page 1 of 1 <br />CERT NO.: 6330099 (AVC) Betty Tran 11/30/2009 9:39:11 AM page 4 of 4