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<br />04/07/2005 a9:45 <br /> <br />7145714209 <br /> <br />PARKS AND RECREATION <br /> <br />PAGE 05 <br /> <br />POLICY NUMlIER: SEE ATTACHED CERTIFICATE <br />ENDT. P7 <br /> <br />COMMERCIAL GENERAL <br />LIABILITY <br />CG ZOlO 03 97 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED --- OWNERS, LESSEES OR <br />CONTRACTORS -- SCHEDULED PERSON OR <br />ORGANIZATION <br /> <br />Thi. endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: THE CITY OF SANTA ANA, <br />ITS OFFICERS, AGENTS, REPRESENTATIVES, <br />EMPLOYEES & VOLUNTEERS, <br /> <br />OR ANY PERSON OR ORGANIZA nON FOR WHOM ADDITION AS ADDITIONAL INSURED <br />USING <br />THIS FORM, AS SPECIFICALLY REQUESTEb IN A WRITTEN CONTRACT OR AGREEMENT. <br /> <br />(Ifno entry appears above, information required ta camplete this endorsement will be shown in the <br />Declarations <br />as applicable to this endorsement.) <br /> <br />Who I. An In.ured (SectIon II) is amended to include as an insured the person or organization shown <br />in ,the .....___. .. _.._n__+_.__. <br />Schedule, bllt only with respecl ta liability arising out of your ongoing operations performed for that <br />insured. <br /> <br />APPROVED AS TO FORM <br /> <br />~z-h_ <br /> <br />LL1Ura Star ~heedy <br />A~,=,(~lOim Cuy AllOrnc,. <br /> <br />Cortincste 10 : 2227218 <br />Mille Attach",.,,! : M.HSS <br />