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i <br /> i <br /> POLICY NUMBER: W86F4588 COMMERCIAL GENERAL LIABILITY <br /> Co 20 10 04 13 <br /> �f <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED' OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> ORGANIZATION <br /> f <br /> This endorsement modifies Insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Organization(s) Location(s)Of Covered Operations <br /> City of Santa Ana, 24 Civic Center Per Contract and/or Agreement <br /> Plaza, Santa Ana, CA 92701 <br /> 1 <br /> 1 <br /> Information required to complete this schedule,if not shown above,will be shown in the Declarations. <br /> i <br /> A. Section II -Who is An Insured is amended to Include S. With <br /> additionalrespect <br /> Ins to he Insurance dst the following add <br /> itional or ed tolu here <br /> as an additional insured the person(s) or <br /> ions <br /> organization(s) shown In the Schedule, but only with apply: <br /> respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" or <br /> damage"or"personal and advertising Injury" caused, "property damage"occurring after: <br /> In whole or in part,by: <br /> 1. All work, including materials, parts or equipment <br /> 1. Your acts or omissions;or furnished In connection with such work, on the <br /> project(otherthan service,maintenance or repairs) <br /> 2. The acts or omissions of those acting on your to be performed by or an behalf of the additional <br /> behalf: Insured(s)at the location of the covered operations <br /> has been completed;or <br /> in the performance of your ongoing operations for the <br /> additional Insured(s) at the location(s) designated 2. That portion of"your work"out of which the Injury <br /> above. or damage arises has been put to its intended use <br /> by any person or organization other than another <br /> However: contractor or subcontractor engaged In performing <br /> operations for a principal as a part of the same <br /> 1. The insurance afforded to such additional Insured project. <br /> only applies to the extent permitted by law;and <br /> 2. If coverage provided to the additional Insured is <br /> required by a contract or agreement,the insurance <br /> afforded to such additional Insured will not be <br /> broader than that which you are required by the <br /> contract or agreement to provide for such <br /> additional insured. <br /> CG 20 10 04 13 Copyright,Insurance Services Office,Inc.,2012 Page 7 of 2 <br />