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<br />~ <br />" <br /> <br />''1"": <br />. <br /> <br />POLICY NUMBER: PH PI" . - )7 <br />FEEDBACK f'OUNDATI~ <br />COMMERCIAL GENERAL UABILlTY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PlEAsE READ IT CAREFULLY. <br /> <br />""'" <br /> <br />ADDITIONAL INSURED - DESIGNATED PERSON OR <br />ORGANIZATION <br /> <br />This endol1lement modifies insurance provided under the follOWing: <br /> <br />COM'v1ERCIAL GENERAL LIABILITY COVERAGE PART. <br />SCHEDULE <br /> <br />Name of Person or Organization: <br />CITY OF SANTA ANA <br />COMMUNITY DEVELOPMENT AGENCY M-25 <br />ATTN: CARLA THOMPKINS <br />P.O. BOX 1988 <br />SANTA ANA, CA 92702 <br /> <br />RE: Additional insu....d wilh respect 10 claims arislng OLII of tha operations and usee performed by or on behalf of the named <br />lI'lsured, such Insurance as is 8f!grded by lI1is po/ioy is primary and Is not additional to or COntributing with any other insurance <br />carried by or for the benefrt of the addition'" insured's, wilh the exception of sole negligence or Wilful misconduct by the City of <br />Santa Ana. <br /> <br />(If no entry appears above, information required to complete this endorsement Will be shown In the DeClarations as <br />applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section 10 Is amended to include as an insured the person or organization shown in the <br />Schedule as an insured but only with respect to liability arising out of your operations or premises owned by or <br />rented to you. <br /> <br />. CG20261185 <br /> <br />COpyrlght, Insurance ~ervlces Of!k:e, Inc., 1984 <br /> <br />o <br /> <br />APPROVED AS -10 tORIvI <br /> <br /> <br />In Ilfa Sheedy <br />lJ~j' l', C"\'.>\ ft rney <br />