Laserfiche WebLink
r 15 :58 JUN 18, 2008 TO: PRO INSLIRRNCE FR: SCHEDL <br />4526817 PAGE: 5!5 <br />POLICY NUMBER: 18113--056'29 COMMERCIAL GENERAL LIABILITY <br />CG 20 It 01 96 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - MANAGERS OR LESSORS OF <br />PREMISES <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />1. Designation of Premises (Part Leased to You): <br />1533 N. CENTURY BLVD. <br />SANTA ANA, CA 927C3 <br />2. Name of Person or Organization (Additional Insured): <br />CITY OF SANTA ANA <br />20 CI9IC CENTER PLAZA <br />SANTA P_NA, CA 97701 <br />3. Additional Premium: <br />150 <br />(If no entry appears above, the information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br />WHO IS AN INSURED (Section 11) is amended to include as an insured the person or organization shown in the <br />Schedule but only with respect to liability arising out of the ownership, maintenance or use of that part of the prem- <br />ises leased to you and shown in the Schedule and subject to the following additional exclusions: <br />This insurance does not apply to: <br />1. Any 'occurrence" which takes place after you cease to be a tenant in that premises. <br />2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or or- <br />ganization shown in the Schedule. <br />CG 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994 Page f of f <br />