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POLICY NUMBER: BKW57695795 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): F City of Santa Ana, its officers, employees, agents, volunteers and representatives 20 Civic Center PlazaM-30 Santa Ana, CA 92702 Location(s) Of Covered Operations Where required by contract Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II - Who Is An Insured is amended to B. With respect to the insurance afforded to include as an additional insured the person(s) these additional insureds, the following addi- or organization(s) shown in the Schedule, but tional exclusions apply: only with respect to liability for "bodily in- This insurance does not apply to "bodily in- jury", "property damage" or "personal and jury" or" property damage" occurring after: advertising injury" caused, in whole or in 1. All work, including materials, parts or part, by: equipment furnished in connection with 1. Your acts or omissions; or such work, on the project (other than ser - 2. The acts or omissions of those acting on vice, maintenance or repairs) to be per - your behalf; formed by or on behalf of the additional in the performance of p Your ongoing insureds at the location of the covered insured(s) operatons for the additional insured(s) at the operations has been completed; or location(s) designated above. 2. That portion of "your work" out of which However: the injury or damage arises has been put t. The insurance afforded to such additional to its intended use by any person or or- insured only applies to the extent permit- ganization other than another contractor ted by law; and or subcontractor engaged in performing operations for a principal as a part of the 2. if coverage provided to the additional in- same project. sured is required by a contract or agree- ment, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. CG 20 10 04 13 o Insurance Services Office, Inc., 2012 Page 1 of 2 REVIEWED BY: EUNICE HEREDIA (PACOF )