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POLICY NUMBER: 76 SBU UQ6313 <br />CHANGE NUMBER: 002 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />BUSINESS LIABILITY COVERAGE FORM <br />SCHEDULE <br />Name Of Additional Insured Person(s) Or Organization(s): <br />THE CITY OF SANTA ANA, ITS OFFICERS, AGENTS, EMPLOYEES 6, VOLUNTEERS <br />Location(s) Of Covered Operations: <br />20 CIVIC CENTER PLAZA, SANTA ANA, CA 92701 <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section C. — Who Is An Insured is amended to <br />include as an additional insured the person(s) or <br />organization(s) shown in the Schedule, but only <br />with respect to liability for "bodily injury", "property <br />damage" or "personal and advertising injury" <br />caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of those acting on your <br />behalf; <br />in the performance of your ongoing operations for <br />the additional insured(s) at the location(s) <br />designated above. <br />Form SS 41 70 06 11 <br />Process Date: 06/24/22 <br />B. With respect to the insurance afforded to these <br />additional insureds, the following additional <br />exclusions apply: <br />This insurance does not apply to 'bodily injury" or <br />"property damage" occurring after: <br />1. All work, including materials, parts or <br />equipment furnished in connection with such <br />work, on the project (other than service, <br />maintenance or repairs) to be performed by or <br />on behalf of the additional insured(s) at the <br />location of the covered operations has been <br />completed; or <br />2. That portion of "your work" out of which the <br />injury or damage arises has been put to its <br />intended use by any person or organization <br />other than another contractor or subcontractor <br />engaged in performing operations for a <br />principal as a part of the same project. <br />R}e�nE�w�m[6Ar�v,.Ro,v®Jer. <br />® Ruk Manager <br />Page 1 of 1 <br />Policy Expiration Date: 07/05/23 <br />© 2011, The Hartford <br />(Includes copyrighted material of Insurance Services Office, Inc., with its permission) <br />