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BA7815084403 (Auto) <br />11$7iR7pAlpA <br />61112012 6/1/2013 <br />CA 20 48 (02 -99) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED <br />This endorsement modifies insurance provided 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 provided by this endorsement, the provisions of the Coverage Form apply unless modified <br />by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision <br />of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />SCHEDULE <br />Name of Persons) or Organization(s): <br />City of Santa Ana Community Development Agency <br />Refer to G- 56015 -8 <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 organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that <br />person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the <br />Coverage Form. <br />Copyright, Insurance Services Office, Inc., 1998 <br />3110 N ?Birch and 4 (Fifthdantl Maln) 420 SrMain in Sanct(Fiesta , CA 2701 annd # 39 2 Street, 3rd M.. Santa Ana, CA <br />92701 <br />CA 20 48 (02 -99) <br />CP.Ol NO.: I�6502022 CLIENT CODE: PA KC Ise 1. C ... ill. 10/23/2012 3:52:57 ON Pa, 5 O2 9 <br />I® 'FovyR <br />0y <br />Sts ar Pttorn <br />LA <br />PS <br />