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POLICY NUMBER: UVEDE104595115 COMMERCIAL GENERAL LIABILITY <br />Chambers Group, Inc. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ |TCAREFULLY. <br />ADDITIONAL INSURED _- OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br />SCHEDULE <br />Name nfPerson orOrganization: <br />The City ofSanta Ana, 2UCivic Center Plaza, Santa Ana, California 027O1; <br />its officers, employees, agents, volunteers and representatives are named as <br />additional insureds <br />(If no entry appears above, information required to complete this endorsement will be shown inthe <br />Declarations oaapplicable tothis endorsemenL) <br />WHO IS AN INSURED (Section U) is amended to include osen insured the person or organization <br />shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for <br />you <br />CG2U1O11 85 Copyright, Insurance Services Office, Inc., 1984 <br />CHAMBERS GROUP A,2U13-OO7-02REVIEWED BY: EUN|CEHERED|A(PG 4OF5) <br />