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POLICY NUMBER: 72 SBM BF5602 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 10 04 13 <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 />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) <br />Or Organization(s) <br />Location(s) Of Covered Operations <br />The City of Santa Ana, its officers, <br />20 CIVIC CENTER PLZ <br />officials, employees, and volunteers <br />SANTA ANA, CA 92701-4058 <br />are additional insureds. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II — Who Is An Insured is amended to B. <br />include as an additional insured the person(s) or <br />organization(s) shown in the Schedule, but only with <br />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 <br />the additional insured(s) <br />designated above. <br />However: <br />ongoing operations for <br />at the location(s) <br />1. The insurance afforded to such additional <br />insured only applies to the extent permitted by <br />law; and <br />2. If coverage provided to the additional insured is <br />required by a contract or agreement, the <br />insurance afforded to such additional insured will <br />not be broader than that which you are required <br />by the contract or agreement to provide for such <br />additional insured. <br />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 equipment <br />furnished in connection with such work, on the <br />project (other than service, maintenance or <br />repairs) to be performed by or on behalf of the <br />additional insured(s) at the location of the <br />covered operations has been completed; or <br />2. That portion of "your work" out of which the injury <br />or damage arises has been put to its intended <br />use by any person or organization other than <br />another contractor or subcontractor engaged in <br />performing operations for a principal as a part of <br />the same project. <br />CG 20 10 04 13 © Insurance Services Office, Inc., 2012 <br />RideMwvgwwdD'iy: <br />REVIEWED & APPRovEO Br. <br />T>ACy J" <br />��� R¢kklanag&nenl Matysl <br />