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COV"ERCIAL GENERAL LIABILITY <br />C#: FUL-58375 Name of Insured: Fullmer Construction <br />Policy Nu~Tiber: PG1001470001 Policy Term: 3101 /00 - 3/01 /01 <br />Eff. DAite: <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -- OWNERS, LESSEES OR <br />CONTRACTORS (FORM 13) <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 AS THEIR INTEREST MAY APPEAR <br />(If no entry appears above, information required to complete <br />this endorsement will be shown in the Declarations as applicable <br />to this endorsement.) <br />WHO IS AN INSURED (Section Ill is amended to include as an <br />insured the person or organization shown in the Schedule, but <br />only with respect to liability arising out of "your work" for <br />that insured by or for you. <br />CG 20 10 11 85 <br />