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POLICY NUMBER: CIP467099 <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 />AS REQUIRED IN WRITTEN CONTRACT WITH THE <br />EMPLOYEES <br />NAMED INSURED <br />AGENTS AND VOLUNTEERS <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92702 <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section If - Who Is An Insured is amended to In- B. <br />clude as an additional insured the person(s) or or- <br />ganizations) shown in the Schedule, but only with <br />respect to liability for "bodily injury", "property dam- <br />age" or "personal and advertising injury" caused, in <br />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) desig- <br />nated above. <br />However: <br />1. The insurance afforded to such additional in- <br />sured only applies to the extent permitted by <br />law; and <br />2. If coverage provided to the additional insured <br />is required by a contract or agreement, the in- <br />surance afforded to such additional insured <br />will not be broader than that which you are re- <br />quired by the contract or agreement to provide <br />for such additional insured. <br />With respect to the insurance afforded to these <br />additional insureds, the following additional exclu- <br />sions apply: <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring after: <br />1. All work, including materials, parts or equip- <br />ment furnished in connection with such work, <br />on the project (other than service, mainte- <br />nance or repairs) to be performed by or on <br />behalf of the additional insureds) at the loca- <br />tion of the covered operations has been com- <br />pleted; 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 princi- <br />pal as a part of the same project. <br />CG 20 10 04 13 Copyright, Insurance Services Office, Inc., 2012 <br />" - RAMompmentDtWekm <br />8 I �Rsvlex+Eo Vme/r: <br />� A4fgf1AEo1/4W4' <br />Rhk Management Specialist <br />v 'M <br />