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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> THE <br /> HARTFORD <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - COMPLETED OPERATIONS <br /> POLICY NUMBER: 72SBABLVTP <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESS LIABILITY COVERAGE FORM <br /> Except as otherwise stated in this endorsement, the terms and conditions of the Policy apply. <br /> The following is added to Section C. WHO IS AN INSURED: <br /> Additional Insured—Owners, Lessees Or Contractors—Completed Operations <br /> a. The person(s) or organization(s) shown in the Schedule on the Declarations is also an additional insured, but <br /> only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" <br /> and at the location designated and described in the Location And Description Of Completed Operations <br /> Schedule in the Declarations performed for that additional insured and included in the "products-completed <br /> operations hazard". <br /> b. With respect to the insurance afforded to these additional insureds, this insurance does not apply to "bodily <br /> injury", "property damage" or "personal and advertising injury" arising out of the rendering of, or the failure to <br /> render, any professional architectural, engineering or surveying services, including: <br /> (1) The preparing, approving, editing of or failure to prepare or approve, shop drawings, maps, opinions, <br /> reports, surveys, change orders, field orders, designs, drawings, specifications, warnings, <br /> recommendations, permit applications, payment requests, manuals or instructions; <br /> (2) Supervisory, inspection, quality control, architectural, engineering or surveying activities or services; <br /> (3) Maintenance of job site safety, construction administration, construction contracting, construction <br /> management, computer consulting or design software development or programming service, or selection <br /> of a contractor or programming service; <br /> (4) Monitoring, sampling, or testing service necessary to perform any of the services included in (1), (2) or (3) <br /> above; <br /> (5) Supervision, hiring, employment, training or monitoring of others who are performing any of the services <br /> included in (1), (2) or(3) above; <br /> c. The insurance afforded to these additional insureds only applies to the extent permitted by law. <br /> d. If coverage provided to these additional insureds is required by a written contract, agreement or written permit <br /> issued by a state or governmental agency or subdivision or political subdivision, the insurance afforded to <br /> these additional insureds will not be broader than that which you are required by the contract, agreement or <br /> permit to provide for these additional insureds. <br /> Name of Person or Organization: <br /> The City of Santa Ana, its officials,employees and volunteers <br /> Location of Covered Operations: <br /> Agreement for Administrative Services,A-2020-119, <br /> City of Santa Ana PARS 3121 Part-Time Social Security <br /> Alternative Retirement Plan.. <br /> Form SL 30 36 10 18 Page 1 of 1 <br /> Process Date: ©2018, The Hartford Policy Expiration Date: <br /> (May include copyrighted material of Insurance Services Office, Inc., with its permission) <br /> 85926200 125-26 CA GL-HNOA-WC, 24-25 PL I Sherry Young 16/25/2025 9:41:22 AM (PDT) I Page 6 of 10 <br />