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POLICY NUMBER; UVEDE104595115 COMMERCIAL GENERAL LIABILITY <br />Chambers Group, Inc. <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -- OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART, <br />SCHEDULE <br />Name of Person or Organization: <br />The City of Santa Ana, 20 Civic Center Plaza, Santa Ana, California 92701; <br />its officers, employees, agents, volunteers and representatives are named as <br />additional insureds <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section ll) is amended to include as an insured the person or organization <br />shown in the Schedule, but only with respect to liability arising out of "your work' for that insured by or for <br />you. <br />CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 <br />CHAMBERS GROUP A-2013-007-02 REVIEWED BY: ��, EUNICE HEREDIA (PG 4 OF 5) <br />