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POLICY NUMBER: PSA0001078 <br />COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage <br />provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: Johnson -Frank & Associates, Inc. <br />Endorsement Effective Date: 12/1/2016 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />City of Santa Ana, its officers and employees <br />Information required to complete this Schedule if not shown above will be shown in the Declarations. <br />Each person or organization shown in the Schedule is <br />an "insured" for Covered Autos Liability Coverage, but <br />only to the extent that person or organization qualifies <br />as an "insured" under the Who Is An Insured <br />provision contained in Paragraph A.I. of Section II — <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph D.2. of Section I — Covered Autos <br />Coverages of the Auto Dealers Coverage Form. <br />REVIEWED BY:EDNICE MEREDIA (PCOF�j� <br />CA 20 48 10 13 O Insurance Services Office, Inc., 2011 Page 1 of 1 <br />36685-114 1 12/16-17 GL/AUT0/L"%CG39/WC/PL I (AVC) Batty Tran 19/13/201] 4,64:14 PM (PDT) I Page 3 of 5 <br />