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<br />~ " <br /> <br />'POLIC1 NUMBER: <br /> <br />260T046801 <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED <br />CONTRACTORS <br /> <br />OWNERS, LESSEES <br />(FORM B) <br /> <br />OR <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />CITY OF SANTA ANA <br /> <br />(If no entry appears above, information required to complete this endorsement will be <br />shown in the Declarations as applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or <br />organization shown in the Schedule, but only with respect to liability arising out of <br />"your work" for that insured by or for you. <br /> <br />IF YOU ARE REQUIRED BY WRITTEN CONTRACT TO PROVIDE PRIMARY INSURANCE, THIS POLICY SHALL BE <br />PRIMARY AS RESPECTS YOUR NEGLIGENCE AND CONDITION 4 OTHER INSURANCE DOES NOT APPLY, BUT <br />ONLY WITH RESPECT TO COVERAGE PROVIDED BY THIS POLICY. <br /> <br />CG 20 10 11 85 <br /> <br />Copyright, Insurance Services Office, Inc., 1984 <br /> <br />APPROVED AS TO FORM <br /> <br /> <br /> <br />1; ura Sheedy <br />Deputy City Attorney <br /> <br />ICG2010P.5AM <br />