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POLICY NUMBER: HDO G21702316 COMMERCIAL GENERAL LIABILITY <br />CG 20 10 03 97 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS <br />SCHEDULED PERSON 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 />CITY OF SANTA ANA <br />PUBLIC WORKS AGENCY <br />220 S. DAISY AVENUE, M85 <br />P.O. BOX 1988 <br />SANTA ANA, CA 92702 <br />RE: West Station Facilities Upgrade. <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to this endorsement. <br />WHO IS AN INSURED (Section 1 1) is amended to include as an insured the person or organization show in the <br />Schedule, but only with respect to liability arising out of your ongoing operations for that insured. <br />CG 20 10 03 97 Copyright, Insurance Services Office, Inc., 1996 <br />APPROVED AS TO FORM <br />W � , <br />Laura Stitt Sheedy <br />rtssistant City Attorney <br />