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Additional Insured — Owners, Lessees or Contractors — AB 90 67 12 93 <br />Policy Amendment Section 11 <br />Insured: Yorba Regional Animal Hospital Policy Number AZC30904163 <br />Producer Veterinary Ins Services Co Effective Date 05/01/15 <br />Schedule <br />Nance of Persons) or Orgunization(s) <br />City of Santa Ana — as required by written contract <br />20 Civic Center Plaza, M29 <br />Santa Ana, CA 92702 <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 Part I — WHO IS AN IN- arising out of your work for that insured by or for <br />SURED in the Business Liability Section of this policy you. <br />5. The person or organization shown in the Schedule All other terms and conditions of the policy apply. <br />is also an insured, but only with respects to liability <br />This form must be attached to Change Endorsement when issued after the policy is written. <br />One of the Fireman's Fund Insurance Companies as named in the policy. <br />Sad (A Nary <br />Secretary <br />m <br />Authorized Agent <br />AB9067 12-95 <br />Contains copyrighted Material of Issuance Services Offices, Ino„ 1984 <br />91GcfiadZ GaVi= <br />President <br />Date <br />05/14/15 <br />