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POLICY NUMBER: 605503396 BUSINESSOWNERS <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - STATE OR POLITICAL <br />SUBDIVISIONS - PERMITS RELATING TO PREMISES <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS POLICY <br />SCHEDULE* <br />State or Political Subdivision: City of Santa Ana, Its officers, agents & Employees <br />The following is added to Paragraph C. WHO IS AN <br />INSURED in the Businessowners Liability Coverage <br />Form: <br />4. Any state or political subdivision shown in the <br />Schedule is also an insured, subject to the follow- <br />ing additional provision: <br />This insurance applies only with respect to the <br />following hazards for which the state or political <br />subdivision has issued a permit in connection with <br />premises you own, rent, or control and to which <br />this insurance applies: <br />a. The existence, maintenance, repair, construc- <br />tion, erection, or removal of advertising signs, <br />awnings, canopies, cellar entrances, coal <br />holes, driveways, manholes, marquees, hois- <br />taway openings, sidewalk vaults, street ban- <br />ners, or decoration and similar exposures; <br />b. The construction, erection, or removal of ele- <br />vators; or <br />c. The ownership, maintenance, or use of any <br />elevators covered by this insurance. <br />* Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Decla- <br />rations. <br />BP 04 07 01 87 Copyright, Insurance Services Office, Inc., 1985 Page 1 of 1 ❑ <br />