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From: 32", 45-9917 To 7145714209 Pacge:3I4 Date. 5/17/20138,58.40 AM <br />POLICY NUMBER: PPK1 009047 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, <br />ADDITIONAL. INSURED . MFRS, LESSEES <br />CONTRACTORS (FOR B) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br />SCHEDULE <br />Name ar Pe rsun or Organization: <br />The City of Santa Ana, its Officers, Agents, Employees, Representatives and Volunteers <br />Parks. Recreation & Community Services Agency <br />P-C3. Box 1988, M-3 <br />Santa Ana, CA 92702 <br />ilf no entry appeam above. information required to complete this endorsetvent will he shown in the Declarations as appticabteto ties <br />£ntf01'3C}1TCtti.i <br />WHO IS AN INSt' RED (Section 11) is amended It, include as an lasured the person, or organization shown in the Schedule, but onIN <br />n=fttt respect to liability raising out of your work for that imurcd by or for you. <br />APPROVED AS TO FOF41'1 <br />C0 20 10 I i. 35 Copynigh€, Insurance Services C)tfice, Inc,- 1434 <br />LISA . STORCK <br />Assistant City Attorney <br />Rick Somber Insurance Services, Inc. 500.446-6227 ?,y <br />Fax from : 329845`4917 85/1.7/3.3 09:01, Pq: 3 11,4