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POLICY NUMBER: PHPK947781 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 26 07 04 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - DESIGNATED <br />PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Ensured Persons Or Organization(s) <br />City of Santa Ana - WIA <br />Its Officers, Employees, Agents, <br />Volunteers & Representatives <br />Information required to complete this Schedule, if not shown above will be shown in the Declarations. <br />Section 11 — Who Is An Insured is amended to in- <br />clude as an additional insured the person(s) or or- <br />ganizations) shown in the Schedule, but only with <br />respect to liability for "bodily injury", "property dam- <br />age" or "personal and advertising injury" caused, in <br />whole or in part, by your acts or omissions or the acts <br />or omissions of those acting on your behalf: <br />A. In the performance of your ongoing operations; or <br />B. In connection with your premises owned by or <br />rented to you. <br />App tO: OAS T.4 FORM <br />LISA F. STORCK <br />Assistant City Attorney <br />CG 20 26 07 04 © ISO Properties, inc., 2004 Page 1 of 1 ❑ <br />a-417 14 - <br />