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i POLICY NUMBER: 01-0041-351 DESIGNATED INSURED FOR COVERED ,AUTOS LIABILITY COVERAGE THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. This endorsement modifies Insurance provided under the following: AUTO?DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement Identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not after coverage provided In the Coverage Foram. This endorsement changes the policy effective on the Inception date of the policy unless another date is Indicated below. Flamed Insured: HUMAN OPTIONS INC l ndorsem®nt Effective Date: 09/23/2024 _ _SGI�II=PULE dame Of Pearson(s)Or Organbation(s). �— City Of Santa Ana, Its City Council,Officers,Agents, Employees,And Volunteers, Community Development Agency,20 Civic Center Plaza, M-25,Santa Ana, Ca 92701 Information required to complete this Schedule, if not shown above,will be shown in the Declarations. Each person or organization shown In the Schedule is an"insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.I. of Section 11 - Covered Autos Liability Coverage In the Business Auto and Motor Carrier Coverage Forms and Paragraph 1D.2.of Section I-Covered Autos Coverages of the Auto Dealers Coverage Form. I i @ Insurance Services Office,Inc.,2011 CA 20 48 10 13 Page 1 of 1 I {