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POLICY NUMBER: 2CN0177-7334 COMMERCIAL GENERAL LIABILITY <br /> CG 20 12 04 13 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - STATE OR GOVERNMENTAL <br /> AGENCY OR SUBDIVISION OR POLITICAL <br /> SUBDIVISION - PERMITS OR AUTHORIZATIONS <br /> This endorsement modifies insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> State Or Governmental Agency Or Subdivision Or Political Subdivision: <br /> City of Santa Ana Risk Management Division <br /> 20 Civic Center Plaza,4th floor <br /> Santa Ana,CA 92702 <br /> The City of Santa Ana,Risk Management, it's officers,employees,agents,representatives,and volunteers as additional inured.Coverage <br /> is primary and not-contributory with respect to insurance or self-insurance maintained by the City. Waiver of Subrogation applies to <br /> general liability.Thirty(30)day prior written notice of cancellation required. <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 2. This insurance does not apply to: <br /> include as an additional insured any state or a. "Bodily injury", "property damage" or <br /> governmental agency or subdivision or political "personal and advertising injury" arising out <br /> subdivision shown in the Schedule, subject to the of operations performed for the federal <br /> following provisions: government, state or municipality; or <br /> 1. This insurance applies only with respect to b. "Bodily injury" or "property damage" <br /> operations performed by you or on your behalf included within the "products-completed <br /> for which the state or governmental agency or operations hazard". <br /> subdivision or political subdivision has issued a <br /> permit or authorization. B. With respect to the insurance afforded to these <br /> additional insureds, the following is added to <br /> However: Section III—Limits Of Insurance: <br /> a. The insurance afforded to such additional If coverage provided to the additional insured is <br /> insured only applies to the extent permitted required by a contract or agreement, the most we <br /> by law; and will pay on behalf of the additional insured is the <br /> b. If coverage provided to the additional amount of insurance: <br /> insured is required by a contract or 1. Required by the contract or agreement; or <br /> agreement, the insurance afforded to such <br /> additional insured will not be broader than 2. Available under the applicable Limits of <br /> that which you are required by the contract Insurance shown in the Declarations; <br /> or agreement to provide for such additional whichever is less. <br /> insured. This endorsement shall not increase the <br /> applicable Limits of Insurance shown in the <br /> Declarations. <br /> \ / <br /> Risk Management Division <br /> : REVIEWED&APPROVED BY: <br /> tin • A4.L:.Q Aa4I€I. <br /> ® Risk Management Specialist <br /> CG 20 12 04 13 ©Insurance Services Office, Inc., 2012 Page 1 of 1 <br />