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POLICY NUMBER: s-r UUN PV0563 COMMERCIAL AUTO <br />CA 20 48 02 99 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED <br />This endorsement modlTies Insurance provlded 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 provlded by this endorsement, the provisions of the Coverage Form apply unless motlifled <br />by this endorsement. <br />This endorsement identlfles persons) or organizatlon(s) who are "Insureds" under the Who Is An Insured Provision of <br />fhe Coverage Forrn. This endorsement does not alter coverage provlded In the Coverage Fottn. <br />This endorsement changes the policy effective on the inception dates �-: the policy unless another date is Indicatetl <br />below. <br />Endorsement effective <br />Ia of II <br />Named Insured <br />KEYSSR MARSTON ASSOCIATBS� INC. <br />Countersigned by <br />SCHEDULE <br />Name of Pereon(a) or Organlzation(s): <br />City o£ Santa Ana, its o££icers, <br />employees, agents, volunteers <br />and representatives <br />�. .....-- ........'., v.av, ..a..., or <br />(If no entry appears above, Information required to complete this endorsement will be shown In the Declarations as <br />applicable to the endorsement.) <br />Each person or organlzatlon shown in the Schedule Is an "insured" for Liability Coverage, but only to the extent that <br />person or organization qualities as an "insured" under the Who Is An Insured Provision contained In Section II of the <br />Coverage Form. <br />S TO ��,��f! <br />�ppR�V � A <br />- --'-�� LISA E.. STORCY <br />Assistant C�tY Atta•>' <br />CA 20 48 02 99 Copyright, Insurance Services O(tice, Inc., 1998 Page 1 of 1 �� <br />