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0 Mitsui Sumitomo Insurance Group <br />THIS ENDORSEMENT CHANGES THE POLICY. 'PLEASE FREAD IT CAIEFULLY. <br />ADD1TIO NAL INSURED - STATE OR POLITICAL <br />SUBDIVISION- OPERATIONS PERFORMED BYOR <br />FOR THE NAMED INSURED <br />This endorsement modifies Insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />Section II - Who is An Insures! Is amended to behalf for the state or political subdivision; <br />include as an insured any state or political or <br />subdivision shown in the Schedule; but only <br />with resPeet to 2. "Bodil i'injury" or <br />Y property damage"' inolud:etl <br />withini'the"produsts-completed operations <br />1. "Bodily injury,." "property darnage" or hazard." <br />"'personal and, advertising Injury" arising out <br />of operations performed by you or on your <br />SCHEDULE <br />Sate or PoI ti0ai Subdivision <br />MIMNICIPALITY-BLANR.ET COVERAGE WHERE REQ?JIRED BY CONTRACT ° <br />FOR <br />WORK PERFORMED ON BEHALF OF A MUNICIPALITY, <br />CITY OF SANTA ANA, CA <br />CITY AND COUNTY OF SAN FRANCISCO, ITS OFFICERS', EMPLOYEES <br />AND AGENTS - <br />THE C.IT`Y OF SAN 'MATEO, ITS ELECTED AND APPOINTED OFFICERS, <br />EMPLOYEES & AGENTS <br />All other terms and conditions remain unchanged, <br />APPROVED AS TO G.,- <br />515 <br />Laura Stitt Shcedy <br />Assistant City Attorn:, <br />MS 6425 03 05 Page 1 of i <br />UKID?WR17lMG COPY