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CNA <br />SB-300120-C <br />(Ed. 06/11) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - <br />SCHEDULED PERSON OR ORGANIZATION - WITH PRODUCTS COMPLETED <br />OPERATIONS COVERAGE <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS LIABILITY COVERAGE FORM <br />SCHEDULE* <br />Name Of Person Or Organization: <br />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza, 4th Floor <br />Santa Ana, CA 92702 <br />Information required to complete this Schedule, if not shown on this endorsement, will be shown in the <br />Declarations. <br />A. The following is added to Paragraph C. Who Is An <br />Insured: <br />4. Any person(s) or organization(s) shown in the <br />Schedule is also an additional insured, but only <br />with respect to liability for "bodily injury," <br />..property damage" or "personal and advertising <br />injury," caused, in whole or in part, by: <br />a. Your acts or omissions; or 2. <br />b. The acts or omissions of those acting on <br />your behalf <br />in the performance of your ongoing operations <br />for the additional insured(s); at the location(s) <br />designated above; or <br />c. "Your work" that is included in the <br />"products -completed operations hazard" <br />and performed for the additional insured, <br />but only if this Policy provides such <br />coverage, and only if the written contract or <br />written agreement requires you to provide <br />the additional insured such coverage. <br />B. The insurance provided to the additional insured <br />does not apply to "bodily injury," "property damage," <br />or "personal and advertising injury' arising out of: <br />1. The rendering of, or the failure to render any <br />professional architectural, engineering, or <br />SIIMPvinn SPrvlrPS inrludinn, <br />SS-300120-C <br />(Ed.06/11) <br />(a) The preparing, approving, or failing to <br />prepare or approve maps, shop drawings, <br />opinions, reports, surveys, field orders, <br />change orders or drawings and <br />specifications; and <br />(b) Supervisory, inspection, architectural or <br />engineering activities. <br />"Bodily Injury," "property damage," or "personal <br />and advertising injury' arising out of any <br />premises or work for which the additional <br />insured is specifically listed as an additional <br />insured on another endorsement attached to <br />this Policy. <br />C. The following is added to Paragraph H. of the <br />Businessowners Common Policy Conditions: <br />H. Other Insurance <br />This insurance is excess over any other <br />insurance naming the additional insured as an <br />insured whether primary, excess, contingent or <br />on any other basis unless a written contract or <br />written agreement specifically requires that this <br />insurance be either primary or primary and <br />noncontributing. <br />REVIEWED & APPROVED <br />By RISk "A"'tEME1Nr DrvI51pN <br />4EU1021,h1?4NCR. VILLAREAL <br />Page 1 of 1 <br />