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POLICY NUMBER: COMMERCIAL GENERAL LIAMLITY <br />CG 20 $7 04 13 <br />THIS ENDORsEmEtxrr CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - COMPLETED OPERATIONS <br />This andraraero nnanf Modifies Insurnopo Provided urlder the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />PRODUUTSICOMPLET-E.'r.) OPERATIONS LIABILITY COVERAne. PART <br />SCHEDULE <br />Name Of Additional Insured Perean(s) Or Org. <br />aiycf-saFg-A-64----- ---- --- <br />Attn: Purchasing Deparnitunt <br />20 Civlo Center Plaza <br />Santa Ana, CA 92701 -0000 <br />Location and Dascription Of Completed OR <br />eon'lolato this Schedule, if not shown above. will be <br />A, Section It - Who is An Insured is arnorded to <br />for Met addttlooal muted and <br />n10 "Prodt'00-0curp;eted oporaflona <br />Howevar: <br />1. The Ins;uranee 11fordod to suoh kddiftrial <br />insured only applies to the extent permItted <br />by Vrvv: and <br />2. If coverage provIded to file additional in.surod <br />Is rsquired by a conuort or agreement, the <br />Insurance afforclocl to such additional Insured <br />Will not be breeder than thch which you are <br />CQ 2037 04 13 <br />1'eqvirad by the contract or aginsefftem to prpvidu <br />tor t ir; Addaionil inaurod. <br />8. With nv*bact to the nusuronce alfisidpul to these <br />additional lnsumde' tho followino is, added to <br />Im Of <br />Section lit:- I-tha husurervcns: <br />If oaverut;jo provided to the additional ln,%irecl Is <br />roquiroq( by a eentrar.t or aQreornont, the most we <br />will pay oo bmian of the additional Insured le (ho <br />amount of insurances: <br />f. f2uqutrH{ it3Y- tftsoS%nPnat'.(otragroatnont: (3r <br />2, Available iundar the appfw abla Limits of <br />Insurance shown in thq Docuarationa; <br />whichever Is less. <br />This ondorsennent of all not Increcuss the appl;cabs <br />Limits of Insurance shown In the Do, bratlons. <br />All terms and conditions apply unless Modified by this endorsement, <br />0 Insurance Sorvloee Office, for -, 2012 <br />Page I of I <br />AS TO FORM <br />LISA E. STORCK <br />Assistant City Att0l"Ov <br />