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POLICY NUMBER: PHPK1924744 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 13 04 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - STATE <br />OR GOVERNMENTAL AGENCY OR SUBDIVISION <br />OR POLITICAL SUBDIVISION - PERMITS <br />OR AUTHORIZATIONS RELATING TO PREMISES <br />This endorsement modifies insurance provided under the following: <br />Isis] diILI:1[Za]01Eel :1011:1:7_104h_1 ]IOIV(Ke1TAAM_C 219-11AI <br />SCHEDULE <br />State Or Governmental Agency Or Subdivision Or Political Subdivision: <br />City of Santa Ana, its officers, <br />employees, agents, volunteers <br />and representatives <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II — Who Is An Insured is amended to <br />include as an additional insured any state or <br />governmental agency or subdivision or political <br />subdivision shown in the Schedule, subject to the <br />following additional provision: <br />This insurance applies only with respect to the <br />following hazards for which the state or <br />governmental agency or subdivision or political <br />subdivision has issued a permit or authorization in <br />connection with premises you own, rent or control <br />and to which this insurance applies: <br />1. The existence, maintenance, repair, <br />construction, erection or removal of advertising <br />signs, awnings, canopies, cellar entrances, <br />coal holes, driveways, manholes, marquees, <br />hoist away openings, sidewalk vaults, street <br />banners or decorations and similar exposures; <br />or <br />2. The construction, erection or removal of <br />elevators; or <br />3. The ownership, maintenance or use of any <br />elevators covered by this insurance. <br />However: <br />1. The insurance afforded to such additional <br />insured only applies to the extent permitted by <br />law; and <br />2. If coverage provided to the additional insured is <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 />B. With respect to the insurance afforded to these <br />additional insureds, the following is added to <br />Section III — Limits Of Insurance: <br />If coverage provided to the additional insured is <br />required by a contract or agreement, the most we <br />will pay on behalf of the additional insured is the <br />amount of insurance: <br />1. Required by the contract or agreement; or <br />2. Available under the applicable Limits of <br />Insurance shown in the Declarations; <br />whichever is less. <br />This endorsement shall not increase the <br />applicable Limits of Insurance shown in the <br />Declarations. <br />CG 20 13 04 13 0 Insurance Services Office, Inc., 2012 <br />tx V <br />Page 1 of 1 <br />