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<br />06~'2;OB WED 12: 07 <br /> <br />FAX 916 923 2791 ARMSTRONG AND ASSOCIATES <br /> <br />Ii/]003/003 <br /> <br />POLICY NUMBER: PSP000621700 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED-OWNERS, LESSEES)R <br />CONTRACTORS (FORM B) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />City of Santa Ana <br />20 Civic Center Plaze - Ross Annex (M-21) <br />Santa Ana, CA 92701 <br /> <br />RE: All California Operations <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 in the <br />Schedule but only with respect to their liability arising out of "'your work" far that insured by or for you. <br /> <br />Coverage provided by this policy to the Additionallnsured[sl shown in the Schedule shall be primary insurance <br />and any other insurance maintained by the Additionallnsured(sl shall be excess and non-contributory, but only <br />as reSDects any claim or liability determined to be the result of the sole negligence or responsibility of the <br />Named Insured and only if required of the Named Insured by written contract. <br /> <br />~ <br /> <br />CG 20 10 11 85 <br /> <br />Copyright, Insurance Services Office, Inc., 1984 <br /> <br />Page 1 of 1 <br /> <br />Fax from <br /> <br />91G 923 2797 <br /> <br />llG/18/B8 <br /> <br />12:11G <br /> <br />Pg: 3 <br />