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r <br />Mar,'J4 05 12c34p <br />Rdrie^ne Ford <br />714-947-9990 <br />p.3 <br />POLICY NUMBER: PHPK041864 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -DESIGNATED PERSON <br />OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person, or Organization: <br />Per Certificate <br />(If no entry appears above, information required to complete this endorsement <br />will be shown in the Declarations as applicable to this endorsement). <br />WHO IS AN INSURED (Section II) is amended to include as an insured the <br />person(s) or organization(s) shown in the Schedule, but only with respect to <br />their liability arising out of your operations or premises owned by or rented <br />to you. <br />APPROVED AS TO FORM <br />�S.Z1 CCO <br />._"ant'_uy Attorney <br />CC 20 26 11 85 Copyright, Insurance Services Office, Inc. 1984 <br />