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POLICYNUMBER: WS383372 COMMERCIAL GENERAL LIABILITY <br />CO 20 10 07 04 <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 Person(s) <br />Or Organlzation(s): Location(s) Of Covered Operations <br />City of Santa Ana, 20 Civic Center City of Santa Ana, CA <br />Plaza., Santa Ana, CA 92701 <br />Information required. .. ...�.�... ..m......_...�..... ,,.. .:..........,.,....... <br />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 Include B. With respect to the Insurance afforded to these <br />as an additional insured the person(s) or additional Insureds, the following additional <br />organlzation(s) shown In the Schedule, but only with exclusions 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 />N. All work, including materials, parts or equipment <br />1. Your eats or omissions; or furnished In connection with such work, on the <br />project (other than service, maintenance or <br />2. The acts or omissions of those acting on your repairs) to be performed by or on behalf of the <br />behalf; additional Insured(s) at the location of the covered <br />In the performance of your ongoing operations tar the operations has been completed; or <br />_ ,_ <br />addthonal Yrisurad(s)' at the tbcatlon(s) iiastg7iate"d` '..._ """ ".. "'."".' .. ' <br />2. That portion of "your work" out of whist, ttia Ittjurp <br />above. or damage arises has been put to Its Intended use <br />by any person or organization other than another <br />contractor or subcontractor engaged In <br />performing operations for a principal as a part of <br />the same project, <br />EV�I E ENT & AMPP R V oD <br />asap <br />F( AKG1NE CZ. VILLAREAL <br />CO 20 10 07 04 Copyright, ISO Properties, Inc., 2004 Page t of 11 <br />