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C H U S B0 Liability Insurance <br />0 Endorsement <br />• <br />• <br />Policy Period JULY 1, 2021 TO JULY 1, 2022 <br />Effective Date SEPTEMBER 15, 2021 <br />Policy Number 3602-52-22 WCE <br />Insured APPLIED 'I'ECHNOLOGY GROUP INC. <br />Name of Company FEDERAL INSURANCE COMPANY <br />Date Issued SEPTEMBER 22, 2021 <br />This Endorsement applies to the following forms: <br />GENERAL LIABILITY <br />Under Who Is An Insured, the following provision is added. <br />Who is An Insured <br />Owners, Lessees Or Persons or organizations shown in the Schedule are insureds; but they are insureds only with respect <br />Contractors - Completed to their liability for bodily injury or property damage caused, in whole or in part, by your work <br />Operations at the applicable location described in the Schedule performed for such person or organization and <br />included in the products -completed operations hazard. <br />However, <br />• the insurance afforded to such person or organization only applies to the extent permitted by <br />law; and <br />• if coverage provided to the person or organization is required by a contract or agreement, the <br />insurance afforded to the person or organization will not be broader than that which you are <br />required by such contract or agreement to provide for the person or organization. <br />Schedule <br />CTI'Y OF SANTTA ANA <br />RISK MANAGEMENTDIVISION <br />20 CIVIC CENTER PLAZA <br />SANTA ANA, CA 92702 <br />Liability Insurance <br />Form 80-02-8"6 (Rev. 3-17) <br />VC <br />Additional Insured - Owners, Lessees Or Contractors - Completed Operations, ScheWveN& APPR rveD SY^ <br />P P �i <br />Endorsement 76v` P�`'�`'°°` <br />.. ._. Risl<WLan sgement Clerical Pu a _. <br />