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09/19/2011 14:32 9189212288 VETERINARY INS SVCS #3704 P.003/005 <br />Additional Insured — Owners, Lessees or Contractors — AB 90 67 12 93 <br />Policy Amendment Section 11 <br />Insured: Serrano Animal 41L Bird Hospital Policy Number AZC80965687 <br />Producer veterinary Ins Services Co Effective !Date 07/0111 1 <br />Schedule <br />Name of Peraon(s) or Organizotion(s) <br />City of Santa Ana, Parks, Recreation A Community Service Agency <br />P.O. Sox 198SM-Z3 <br />Santa Ana, CA 92702 <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 />The following Is Added to Part I — WHO IS AN IN- <br />SURED In the Business Liability Section ofthis policy <br />S. The person or organization shown in the Schedule <br />is also an insured, but only with respects to liability <br />arising out of your work for that insured by or for <br />you. <br />All other terms and conditions ofthe policy apply. <br />This form must be attaohed to Change Endorsement when Issued after the policy is written. <br />One of the Fireman's Fund Insurance Companies as named in the policy. <br />secretary <br />5Z:a4fls -&-0 <br />Authorimd Agent <br />A69067 12-93 <br />Conlshu mpyrichted Mraerial of Insu— Services Offices. h—. 1964 <br />91fiefianiGE. Lamocco <br />President <br />Date <br />