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POLICY NUMBER: N913P533543 BUSINESSOWNERS <br /> BP 04 48 0106 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED -" DESIGNATED PERSON <br /> OR ORGANIZATION <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESSOWNERS COVERAGE FORM <br /> SCHEDULE <br /> Name Of Additional Insured Persons Or Organization s : <br /> City of Santa Ana, its City Council, officers, officials, employees, agents, and volunteers <br /> Information re uired to cam lets this Schedule, if not shown above, will be shown in the Declarations. <br /> The following is added to Paragraph C. Who Is An <br /> Insured in Section II—Liability: <br /> 3. Any person(s) or organization(s) shown in the <br /> Schedule is also an additional insured, but only <br /> with respect to liability for "bodily injury", "property <br /> damage" or "personal and advertising injury" <br /> caused, in whole or in part, by your acts or omis- <br /> sions or the acts or omissions of those acting on <br /> your behalf in the performance of your ongoing <br /> operations or in connection with your premises <br /> owned by or rented to you. <br /> BP 04 48 0106 © ISO Properties, Inc., 2004 Page 1 of 1 13 <br />