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<br />"" <br /> <br />f <br />INSURED <br />Rebuilding Together Orange <br />625 S. cypress <br />Santa Ana CA 92701 USA <br /> <br />County <br /> <br />CG 20 10 11 85 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />ADDITIONAL INSURED <br />CONTRACTORS (FORM B) <br /> <br />OWNERS, LESSEES OR <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br /> <br />Name of Person or organization: City of Santa Ana <br /> <br />project: <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in <br />the Declarations as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization <br />shown in the schedule, but only with respect to the liability arising out of "your work" for <br />that insured by or for you. <br /> <br />CG 20 10 11 85 <br /> <br />Copyright, Insurance services office, Inc., 1984 <br /> <br />A~'''RO'' <br />-..t _Ci - ,( C 2) A..S TF~ ~'~'t'")~)!I. If <br />'-'" .. .........,...1\'1 <br /> <br />~?/L <br /> <br />Laura \'t:;.-t -':~"'-:-7 <br />_ _ _ ...1 ,'-. ._)i,,__':":uy <br />ASSIstant City AtLGr-.cy <br /> <br />Certificate No : <br /> <br />570021672930 <br /> <br />