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POLICY NUMBER: 6809801177714 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 but only with respect to liability arising out of your acts or omissions. <br />1..1SA �• �iC1�G� <br />A55tstant C,ky Fttorr+PY <br />J rr(///J q <br />CC T4 91 1188 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 <br />