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ENDORSEMENT CHANGES THE POLL• (. PLEASE READ ITCAREFULLY, <br />POLICY <br />FARMERS 16840 <br />INSURANCE 2nd Edition <br />AL INSURED - SCHEDULED PERSON <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS LIABILITY COVERAGE FORM <br />BUSINESSOWNERS COMMON POLICY CONDITIONS <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unl ass modified by the <br />endorsement. <br />SCHEDULE <br />'Name Of Additional Insured Per n(s) CITYOFSANTAANA,ITSOFFICERS <br />Or Organization(s): EMPLOYEES, AGENTS & VOLUNTEERS <br />II <br />Location Of covered Ope tion(8): 12723 PARK ST <br />CERRII'OSCA90703 <br />Effective Date Of Endors ment: 10/28/19 If no entry appears above, f formaion required to complete this endorsement wllibeshown In the Decla dons. _1I <br />The BUSINESSOWNERS LIA131LITY COVERAGE FORM is amended as follows: <br />A. With respect to theadd tional Insured described In Paragraph B. of this endorsement, the following e) cl Uslons are added <br />to Paragraph 1. Applicable To Business Liability Coverage under Section B.Exclusions: <br />This insurance does not apply <br />1. "Bodily injury" or ' rope damage" for whkh the additional insured(s) is obligated to <br />the assumption of I ability in a contract or agreement. This exclusion does notapply to liability for dam ge thatthe <br />additional insured( )would have In the absence ofthecontract or agreement. <br />Z. 'Bodily Injury" or" ropedamage" occurring after: <br />a. Your ongoing operat ons at the location of covered operations other than service maintenance or repairs <br />performed by you or on your behalf have been completed: or <br />b. The portion of your ongoing operation out of which the "bodily Injury" or "property damage" arises has been <br />PuttoltsintenqieduseIIby any person or organization. <br />But in no event shal this In'urance apply to"bodily injury" or "property damage" arising out ofyour operations that <br />were completed prior to the effective date ofth is endorsemen t. <br />3. "Bodily injury" or " 3roperty damage" arising Out Of any act or omission of the additional insu d(s) or any of its <br />"employees", agen s or c tractors other than you, except for general supervision by the addit onal insured(s) of <br />yourongoing opera Ions performed for thatadditional insured. <br />4. "Property damage" o: <br />a. Property owne , used or occupied by or rented to the additional lnsured(s); <br />b. Property in thE care cUstody or control of the additional insured(s) or over which the ad itional Insured(s) <br />exercise physic if control; or <br />c. Any work inclu g m�terials, parts or equipment furnished in connection with such work hich is Performed <br />fortheaddMon sured byyou. <br />j6840-209-18 <br />ED�c des copyrighted material of Insurance Services office, Inc., with its pe,missron. <br />93 6e4o Page 1 of 2 <br />1 J6840201 <br />