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COMMERCIAL AUTO <br />CA83071013 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED ENDORSEMENT <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified <br />by the endorsement. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Endorsement Effective: 10/1/2025 <br />Countersigned By: <br />Authorized Representative <br />Interval House <br />SCHEDULE <br />Name and Address of Additional Insured: <br />City of Santa Ana, its officers, agents, employees and volunteers <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br />A. SECTION II - Who Is An Insured is amended to include as an insured the person(s) or organization(s) shown in <br />the Schedule, but only with respect to their legal liability for acts or omissions of a person for whom Liability <br />Coverage is afforded under this policy. <br />B. The additional insured named in the Schedule or Declarations is not required to pay for any premiums stated in <br />the policy or earned from the policy. Any return premium and any dividend, if applicable, declared by us shall <br />be paid to you. <br />C. You are authorized to act for the additional insured named in the Schedule or Declarations in all matters <br />pertaining to this insurance. <br />D. We will mail the additional insured named in the Schedule or Declarations notice of any cancellation of this <br />policy. If we cancel, we will give ten (10) days notice to the additional insured. <br />E. The additional insured named in the Schedule or Declarations will retain any right of recovery as a claimant <br />under this policy. <br />THIS ENDORSEMENT MUST BE ATTACHED TO A CHANGE ENDORSEMENT WHEN ISSUED AFTER THE <br />POLICY IS WRITTEN. <br />CA 83 07 10 13 Includes material copyrighted by Insurance Services Office, Inc., Page 1 of 1 <br />with its permission <br />