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POLICY NUMBER: NX1XYQQQ3-03-GI. COMMERCIAL GENERAL LIABILITY <br /> CG 20 10 04 13 <br /> THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> ORGANIZATION <br /> This endorsement modifies Insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name Of Additional Insured Porson(s) <br /> Or Organizatian(s) Locations Of Covered Operations <br /> City of Santa Ana,its city counsels,officers,officials, CA <br /> employees,agents,and volunteers <br /> 2 Civic Center Piz#M-23 <br /> Santa Ana,CA 9270 <br /> i <br /> t <br /> { <br /> information required to complete this Schedule, if not shown above,will be shown in the Declarations, <br /> A. Section It -� Who Is An Insured Is amended to 8. With respect to the Insurance afforded to these <br /> include as an additional Insured the person(s) or additional Insureds, the following additional <br /> $ organization(s) shown in the Schedule, but only exclusions apply: <br /> with respect to liability for"bodily injury" "property This insurance does not apply to "bodily injury" or <br /> damage" or "personal and advertising Injury" "property damage"occurring after: <br /> caused,in whole or In part, by: <br /> 1. Your acts or omissions;or 1. All work, including materials, parts or <br /> equipment furnished In connection with such <br /> 2. The acts or omissions of those acting on your work, on the project (other than service, <br /> behalf; maintenance or repairs) to be performed by or <br /> In the performance of your ongoing operations for on behalf of the additional Insured(s) at the <br /> the additional Insured(s) at the location(s) location of the covered operations has been <br /> designated above. completed;or <br /> However: 2. That portion of "your work" out of which the <br /> Injury or damage arises has been put to its <br /> 1. The insurance afforded to such additional Intended use by any person or organization <br /> insured only applies to the extent permitted by other than another contractor or subcontractor <br /> law; and engaged In performing operations for a <br /> 2. If coverage provided to the additional Insured Is principal as a part of the same project. <br /> required by a contract or agreement, the <br /> insurance afforded to such additional insured <br /> will not be broader than that which you are <br /> required by the contract or agreement to <br /> provide for such additional Insured. <br /> CG 2010 0413 O Insurance Services office, Inc„2012 Page 1 of 2 <br /> I <br />