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09/19/2011 14:32 9189212268 <br />VETERINARY INS SVCS <br />#9704 P.003/005 <br />Additional Insiured — Owners, Lessees or Contractors — AB 90 6712 93 <br />Policy Amendment Section II <br />cured: SerrAno Animal & 81rd Hospital eglia Number AZC80965687 <br />Produce veterinary Ins Services Co ;Effective Date 07/01/11 <br />Schedule <br />Name of Person(s) or Organization(s) <br />City of Santa Ana, Parks, Recreation dt Community Service Agency <br />P.O. Box 1988M-23 <br />Santa Ana, CA 92742 <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 Port 1— WHO IS AN IN- <br />SURFq in the Business Liability Sectlon of this policy <br />5. The person or organization shown in the Schedule <br />is also an insured, bltt 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 of the policy apply. <br />This form must be attached to Change F'ndorsement when Issued after the policy is written. <br />One of the Fireman's Fund insurance Companits as named in the policy. <br />malty to ffo <br />Swrewry <br />z -& <br />A411)0riwd Agent <br />A139067 12.9E <br />ContRim copyrighted Msterisi of Insurance Sorvioes O1Tjces, IN,.1914 <br />gLielrasm Lita"co <br />President <br />Date <br />9/19/11 <br />