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POLICY NUMBER', MP 0004009007964
<br />COMMERCIA L GEN ERAL LIABILITY
<br />CG 2010 04,113
<br />MUL 14;4�7mm **A 4
<br />Th is ond orsernerit mc,Wies insuraive Provided u odler the followirgi;
<br />COMMERCIAL GENERAL LIABILITY COVERAGE PART
<br />SCHEDULE
<br />Name Of Addifionall In amd Persan(s) Location(s), Of Covered Operations
<br />THE CITY OF SANTA ANA, ITS OFFICERS,
<br />EMPLOYEES, ACENTS AND REP RESENTATIVEM
<br />RISX MAN&GEhMNT
<br />P,0. Box 1988 H-16
<br />�W'TA ANA, CA 927,02,
<br />.... ..... .... ... ... .... .... .... ......
<br />Information rug quiredlo complete this Schedule, If not shown a b o v e Witt 11 be shown in the Dedarations
<br />A. Setfin III —'Who Is An Insured is amended to
<br />Include as an additional Insured the person(s) or,
<br />organization(s) shown in Me Schedule, but only
<br />with respect to hability for wbodily injIury", ",property
<br />darnai or, '"prrr^sruraall arradi advei Injury"'
<br />caused, In wWe or In part, by�
<br />1. Your acts or omissions; or
<br />,2. The acts or omissions of, those acting on your,
<br />behal1i;
<br />in the performance of your origoing operationfor
<br />the aiddItionall Insured(s) at the location(s)
<br />designated above,
<br />However.
<br />1. The Insurance afforideld to, such additional
<br />insured only appties to the exten't pemilitted by
<br />Iaw; and
<br />2. If coverage provided to the addillihall Insured Is
<br />required by a contract or agreerneint, the
<br />insurance aff'or ded to such additional Insured
<br />will not be broader than M, t whicih, you are
<br />required by the contract or agreement to
<br />provide f6r, such add Ifional Insure d,
<br />B. With resperiat. to, the insurance afforded to 11 iese
<br />addiltionall Insureds, the followIng additional
<br />exclusions apply�,,
<br />Tis Insarance does not, apply to "bodily Injury" or
<br />"property damagell omothi after,
<br />1 . Ail work, Including matedails, ,parts a,r
<br />equipment furnished In connection with such
<br />work, on the pryw:t (91her than service,
<br />maintenance, or repairs) to be performed by or
<br />ori behall war the additional irisured(s) atfite
<br />location of' the covered aparations hors been
<br />complellet Or
<br />2. That portion of 'Your work' out of volilch the,
<br />Injury or darnage arises has been put to its,
<br />Intended use by any, person or organization
<br />other, thain another contractor or, subcontractor
<br />eingaged in perforn,flng operations for a
<br />principal as, a pad, of the, saii project.
<br />CG 20 10 041 0 inSUirance Services Office, I nci., 2012
<br />Irnauxed ii
<br />cF Risk MmVmerdDMsiun
<br />Jy? 'K�q REVIEWED & APPROVED BY.-
<br />F04c.�" P, VX*vd
<br />Rtiementftali
<br />
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