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<br />~ ~ <br /> <br />COMMERCIAL GENERAL LIABILITY <br />Valley Oak Systems Inc. <br />Policy Number 3582-10-16-PLE <br />Federallnsurance/Chubb <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS <br />(FORM B) <br /> <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />The City of Santa Ana, Its Officers, Agents, Employees, and Volunteers. <br /> <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 /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown <br />in the Schedule. but only with respect to liability arising out of your ongoing operations performed for that <br />insured. <br /> <br />SUCH INSURANCE AS IS AFFORDED BY THE GENERAL LIABILITY POLICY <br />IS PRIMARY INSURANCE AND NO OTHER INSURANCE OF THE ADDITIONAL INSURED <br />WILL BE CALLED UPON TO CONTRIBUTE TO A LOSS. <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br /> <br />CO 2010 1093 <br /> <br />, TQ FORM <br />APl'W..o\(ED (\Si 'i ,I <br />, i," l" - JL_, <br />I '1' f ----r .~ <br />'\! \, ~ '" / \,." I, <br />~~~,.~'\ ~/i-g,li0tta <br />. . C;ty t\ttorney <br />Dcrll\\ " ' <br />