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POLICY NUMBER: NXTQF49PC3-00-GL <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 Organizations) <br />Locations Of Covered Operations <br />The City of Santa Ana, its officers, officials, employees, and <br />CA <br />volunteers <br />20 Civic Center Plz <br />Santa Ana, CA 92701 <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 <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 />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 />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 />However: 2. <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 <br />will not be broader than that which you are <br />required by the contract or agreement to <br />provide for such additional insured. <br />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 />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 />RiskMeugwn DiWlon .. <br />nENAMM 6 APPROVED SY: <br />Risk Management Specialist <br />OF <br />CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 2 <br />