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POLICY NUMBER: BA9361L484 <br />COMMERCIAL AUTO <br />CA20481013 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />B-H."1111 11613 <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <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 person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage <br />provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: Project Partners <br />Endorsement Effective Date: 4 / 12 /2 016 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): The City of Santa Ana, its officers, employees, <br />agents, volunteers and representatives <br />Information required to complete this Schedule, if not shown above will be shown in the Declarations. <br />Each person or organization shown in the Schedule is <br />an "insured" for Covered Autos Liability Coverage, but <br />only to the extent that person or organization qualifies <br />as an "insured" under the Who Is An Insured <br />provision contained in Paragraph A.1. of Section II — <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph D.2. of Section I — Covered Autos <br />Coverages of the Auto Dealers Coverage Form. <br />CA20481013 <br />© Insurance Services Office, Ind., 201 <br />REVIEWED <br />BY: <br />__..m...____._...._.____.rv--Page- .. - <br />1 <br />