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POLICY NUMBER: 6809BOI177714 <br />COMMERCIAL GENERAL LIABILITY <br />ISSUE DATE: <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED- DESIGNATED PERSON <br />OR 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 <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule as an insured butonly with respect to liability arising out of your acts Or omissions. <br />P55 \5tant ���t�'W'a <br />I <br />CG T4 91 11 89 Copyright Insurance Services Office, Inc., 1984 Page 1 _of 1 <br />