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POLICY NUMBER: GL 436 08 71 COMMERCIAL GENERAL LIABILITY <br />CG 2012 05 09 <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 PAR a <br />SCHEDULE <br />State Or Govemmental Agency Or Subdivision Or Political Subdivision: <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />I <br />1 <br />Infomiation re uired to complete this Schedule if not shown above, will be shown In the Declarations <br />Section II — Who Is An Insured is amended to in- <br />clude as an insured any state or governmental <br />agency or subdivision or political subdivision shown in <br />the Schedule, subject to the following provisions: <br />1. This insurance applies only with respect to opera- <br />tions performed by you or on your behalf for which <br />the state or governmental agency or subdivision or <br />political subdivision has issued a permit or au- <br />thorization. <br />2. This insurance does not apply to: <br />a. 'Bodily injury" "property damage" or "personal <br />and advertising injury" arising out of operations <br />performed for the federal government, state or <br />municipality, or <br />b. "Bodily injury" or "property damage" included <br />within the "products -completed operations <br />hazard'. <br />CG 20 12 05 09 0 Insurance Services Office, Inc_, 2008 Page 1 of 1 0 <br />