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POLICY NUMBEA: BOP9S1fi255 <br />BUSINESS OWNERS <br />BP54155102 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />ADDITIONAL INSURED -OWNERS OR OTHER <br />INTERESTS FROM WHOM LAND HAS BEEN <br />LEASED <br />This eod¢rsement modikes icswance provided under the following <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE' <br />Name Of Person Or Organization: <br />sentatives <br />City of Santa Ana, its officers, agents, employes and repre <br />City Attorney Offic¢ <br />20 Civic Center Plaaa <br />Santa Ana, CA 92702 <br />Designation of Premises jPatt Leased To You) <br />? InformatlcorequiredlocempletethlsSchetlule,ifnotshow'noolhlsentlorsement,willbeshown'mfheDecla- <br />ralions. <br />The fallowing is added to Paragraph C. Who Is An <br />Insured in Section II-Liability <br />4. The person of orgaoi:aVon showdm the Schedule <br />Is also an insured, but only with respect to liability <br />arising out of the ownership, maintenance or use <br />of Ihat pad of the land leased to you and shown in <br />the Schedule and subjectlc the following atltli- <br />tionalexclusions: <br />This insurance does not apply lo'. <br />a. Any"occurrence"thalfakesplaceafleryou <br />cease (o lease Thal land; Sr <br />b. Struoluralalteradons,newcensfmcflo5or <br />tlemo9tion operations pedormetl by or for the <br />person or organUafion shown'm the Schedule. <br />ApPRQyED AS RO F?? <br />LISP E, ST? tlomeY <br />Assistant City <br />BP 0410 07 02 ISO Properties, Inc <br />Page 1 of 1