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<br /> <br /> <br /> <br /> POLICY NUMBER: BA507OL837 COMMERCIAL AUTO <br /> California Surveying Corporation ISSUE DATE: 7/16/2010 <br /> and The Martin Lloyd Corporation <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br /> DESIGNATED INSURED <br /> <br /> This endorsement modifies insurance provided under the following: <br /> <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 /> <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 and employees <br /> <br /> <br /> <br /> <br /> <br /> (If no entry appears above, information required to complete this endorsement will be shown in the <br /> Declarations as applicable to the endorsement.) <br /> <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 /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> CA 20 48 02 99 copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 <br /> CERT NO. 7831684 (AVC) Betty Tran 7/16/2010 9:30:18 AM Page 4 of 4 <br />