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FA <br />POLICY NUMBER: PSA0001078 <br />COMMERCIAL AUTO <br />CA 20 48 02 99 <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 unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- <br />sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indi- <br />cated below. <br />Endorsement Effective: 12/1/2012 <br />Countersign <br />_.1WW,,1,.X_ _� �Zq�� <br />Authorized Representative) <br />Named Insured: Johnson -Frank & Associates, Inc. <br />SCHEDULE <br />Name of Person(s) or Organization(s): <br />City of Santa Ana, its officers and employees <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent <br />that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained <br />in Section 11 of the Coverage Form. <br />CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ❑ <br />CERT NO.: 14799125 Teresa Frank 11/28/2012 4:14:30 PM Page 3 of 4 <br />