Laserfiche WebLink
POLICY NUMBER: 648161463 <br />1914.1 <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 />COMMERCIAL AUTO <br />CA 20 48 02 99 <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement <br />This endorsement identifies persons) or organization(s) who are "insureds" under the Who Is An Insured <br />Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is <br />indicated below. <br />SCHEDULE <br />Name of Person(s) or Organization(s): <br />THE CITY OF SANTA ANA <br />CONNUINITY DEVELOPMENT AGENCY <br />ADMINISTRATIVE SERVICES DIVISION M-25 <br />20 CIVIC CENTER PLZ <br />SANTA ANA, CA USA 927014058 <br />AS 'ro F0,514 <br />OvaSTOFCY, <br />, �CIOVZC�yl� <br />��,�.J�sp, F. <br />pttorneY <br />Assistard City <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an "insured" Far Liability Coverage, but only to the extent <br />that person or organization qualifies as an "insured' under the Who Is An limited Provision contained <br />in Section 11 of the Coverage Form. <br />CA 20 48 02 99 Copyright, Insurance Services Office, Inc,, 1998 Page I of I Cl <br />