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1932013(10143 700369 <br />F1011,eymumbar: AS2-681-004-145-725 <br />Issued by- 4jberty mutual gj.re Insurance co, <br />':ZVA��Idf 7-UriANZ-FSTHE POLICY. PLIFASE READ IT CAREFULLY. <br />DESiGNATED INSURED - NONCONTRIBUTING <br />This endorsement modifies insurance provided under the foffowjng: <br />BUSINESS AUTO t',0VERAGF FORM <br />GARAGE COVSRACj: rZORM <br />MOTOR CARRIERS C0VFPAGFF0kM <br />TRUCKERS COVERAI, E IZOF�M <br />With respect to Mve�nagp provided by this endarsenient, the Provisions of the Coverage Form apply unless <br />modified by this endorsement <br />This endorsement identifies, person(s) or organization(s) who are "insureds" under the Who Is An Insured <br />Provision of the Coverage Form. 1'tijs endorsement does not alter coverage provided in the Coverage forma. <br />City Of Santa Ana, 'Ls Officers, emP]QYec-,,, qgents and represenLcjtivc.,� <br />Each person or organizatlon shown in the Schedule of this endorsement is an 'insured" for UaWy Coverage, but <br />Drily to the extent that perscri or Organization qualifies as an Insured" under die Mo Is An Insured Provision <br />Contained in Sartion If of ffie Coverage Form. <br />The following is added to the Other Insurance Conditioll, <br />If You have agremed fil a wjjtterj agrcoment t9,aat fjjit ')y (�4CY Will L* PdMat), and Wfthout right ed" cors utution <br />h'or'nh'or'narty rnsvrance in force for an Ad(fitioria� Insmnad for fizilAfty arW rig out of your operations, and the <br />agreement was executed prior to the "bodily injury" Or 'property darnage", then this insurance will be <br />primary and we will not seek contHbution from such insurance. <br />AC 84 2'3 00 11 (�) 2010,, Ub:erty Mutual GfOuP of Companies, All rights reserved, Page I of I <br />Includes copyrighted material of Ihsairance Services Officta, Inc, <br />with As Permission. <br />F,'EVVVED BY: <br />