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PI-MANU-1 (01l00) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br />Primary wording - City of Santa Ana <br />ADDITIONAL INSURED - DESIGNATED PERSON] OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMERCIAL GENERAL LIABILITY COVERAGE PART. <br />SCHEDULE <br />Name of Person or Organization: City of Santa Ana <br />(If no entry appears above, information required to complete this <br />endorsement will be shown in the Declarations as applicable to thin <br />endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the <br />person or orgar_ization shown in the Schedule as an insured but only with <br />respect to liability arising out of your operations or premises owned by or <br />rented to you. <br />THIS D7SUR1INCE I5 PRIPIARY AND NOT CONTRIBUTING WITH ANY OTHER INSURANCE OP. <br />SELF-INSURANCE CONTRACT OR POLICY. <br />All other terms and conditions of this Policy remain unchanged. <br />Page 1 of 1 <br />APPROVED AS TO FORM <br />�E, sTORCK <br />Assistant City Attcrnev <br />3/� <br />