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POLICY NUMBER: 605503396 BUSINESSOWNERS <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSUR■ED - STATE OR POLITICAL <br />I <br />SUBDIVISIONS - PERMITS RELATING TO PREMISES <br />This endorsement modifies insurance provided under the following: <br />BUSIN�ESSOWNERS POLICY <br />State or Political Subdivision:: City of Santa Ana, Its officers, agents & Employees <br />Thi%; " rNOAH -0, WAIg Is ad-lde d to Paragraph Gi. '00,10 IS A nM <br />114 <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 />111T11 1�1 1� 111 1! <br />11 <br />a. I Ine exisitunce, motainWenance, repair, conathu-0- <br />ton, erection, or removal of advertising signs, <br />awnings, canopies, cellar entrances, coal <br />holes, driveways, manholes, marquees, hols- <br />taway openings, sidewalk vaults, street ban- <br />ners, or decoration and similar exposures-, <br />b. The construction, erection, or removal of eW <br />vators; or <br />c. The ownership, maintenance, or use of any <br />elevators covered by this Insurance. <br />BP'04 07 0187 Copyright, Insurance Services Office, Inc., 1985 Page 1 of I A <br />