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<br />POLICY NUMBER: 6320017981 02 <br /> <br />COMMERCIAL GENERAL LIABILITY <br />LG CG 201002 06 <br /> <br />THIS ENDORSEMENT CHANGES THE POUCV. PLEASE READ IT CAREFULL V. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION INCLUDING PRIMARY COVERAGE <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(s) or Organlzation(s); Locatlon(s)of covered operations; Additlonallnsurecl(s) Address: <br />CITY OF SANTA ANA <br />RE: ALL PROJECTS EXCEPT ROOFING, FRAMING & FOUNDATION WORK AS A <br />SUB-CONTRACTOR, FOR THIS ADDITIONAL INSURED DURING THIS POLICY TERM. <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA USA 92701-0000 <br /> <br />(If no entry appears above, information required to complete this schedule, if not shown above, will be shown in <br />the Declarations. <br /> <br />A. Section 11- Who Is An Insured is amended to <br />include as an insured the person(s) or organiza- <br />tion(s) shown in the Schedule, but only with re- <br />spect to liability for ''bodily injury., "property dam- <br />age" or "personal and advertising injury. caused, <br />in whole or in part, by: <br /> <br />1. Your acts or omissions; or <br /> <br />2. The acts or omissions of those acting on <br />your behalf; <br /> <br />in the performance of your ongoing operations <br />for the additional insured(s) at the location(s) <br />designated above. <br /> <br />B. With respect to the insurance afforded to these <br />additional insureds, the following exclusions ap- <br />ply: <br /> <br />This insurance does not apply to "bodily injury" <br />or "property damage" occurring after: <br /> <br />(1) All work. including materials, parts or <br />equipment furnished in connection with <br />such work, on the project (other than ser- <br />vice, maintenance or repairs) to be per- <br />formed by or on behalf of the additional <br />insured(s) at the location of the covered <br />operations has been completed; or <br /> <br />(2) That portion of "your work" out of which <br />the injury or damage arises has been put <br />to its intended use by any person or or- <br />ganization other than another contractor <br />engaged in performing operations for a <br />principal as part of the same project. <br />C. The insurance afforded by the policy to the Addi- <br />tionallnsured(s) listed in the Schedule for the de- <br />scribed location(s) is primary insurance. Any other <br />insurance or self-insurance maintained by the Addi- <br />tionallnsured(s) is excess of this insurance and <br />shall not contribute to it. <br /> <br />./ ~.-- ~-,. <br /> <br />PC.- <br />c~.~ . <br />/ ') . .) .' <br />_ . ....... c::_.-<e_) ./ !_~ <br /> <br />LG CG 20 10 02 06 <br /> <br />Contains Copyrighted Material of the Insurance Services Office, Inc <br />2004 <br /> <br />Page 1 of 1 0 <br /> <br />- <br /> <br />Producer Copy <br />