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Coast Live Oak School <br />POLICY NUMBER: PHPK771929 COMMERCIAL <br />GENERAL LIABILITY <br />CG 20 26 11 85 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - DESIGNATED PERSON OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br />SCHEDULE <br />Name of Person or Organization: <br />City of Santa Ana; Parks, Recreation <br />and Community Services Agency <br />Attn: Carmen Acosta <br />The City of Santa Ana it's officers, agents and employees are hereby added as Additional Insured as per form CGS <br />Insurance provided is Primary and Non -Contributory. <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization <br />shown in the Schedule as an insured but only with respect to liability arising out of your operations <br />or premises owned by or rented to you. <br />CG 20 26 11 85 <br />© Insurance Services Office, Inc_, 1984 <br />CERT NO. 11351-)62 CLIENT CODE. CO -06 R—in Holloway 10/10/2011 --2 PM Page 3 0£ 3 <br />