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<br />POLlCYNUMBE~ CBP9821629 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES or <br />CONTRACTORS (FORM B) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />City of Santa Ana Community <br />Redevelopment Agency <br />20 Civic Center Plaza M-21 <br />P.O. Box 1988 <br />Santa Ana, CA 92702 <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. <br /> <br />Additional Insured Schedule Continued: The Santa Ana Empowerment <br />Corporation and the City of Santa Ana, their respective officers, <br />employees, agents, volunteers and representatives <br /> <br />þß~/¿;/ <br /> <br />/ <br />¿/ IV <br />/ / I ~ <br /> <br />CG20101185 <br />