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Effective Date: 5/1/2025 PolicyNumber: ENCo004485-o6 <br /> Endorsement Number: 5 <br /> ADDITIONAL INSURED — STATE OR GOVERNMENT AGENCY OR SUBDIVISION OR POLITICAL <br /> SUBDIVISIONS— PERMITS OR AUTHORIZATIONS <br /> In consideration of a premium change of, this endorsement modifies insurance provided under the <br /> following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> All other terms and conditions of this Policy remain unchanged. <br /> SCHEDULE <br /> State Or Governmental Agency Or Subdivision Or Political Subdivision: <br /> City of Santa Ana <br /> Risk Management Division <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 <br /> Declarations. <br /> Section II —Who Is An Insured is amended to include as an insured any state or political subdivision shown <br /> in the Schedule, subject to the following provisions: <br /> 1.This insurance applies only with respect to operations performed by you or on your behalf for <br /> which the state or political subdivision has issued a permit. <br /> 2.This insurance does not apply to: <br /> a. "Bodily injury," "property damage" or"personal and advertising injury" arising out of <br /> operations performed for the state or municipality; or <br /> b. "Bodily injury" or "property damage" included within the "products-completed operations <br /> hazard". <br /> CG 20 12 07 98 ©Insurance Services Office, Inc. Page 95 <br />