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POLICY NUMBER: 2CN0177-7334 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 12 04 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - STATE <br />AGENCY OR SUBDIVISIO <br />SUBDIVISION - PERMITS OR <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />N <br />OR GOVERNMENTAL <br />OR POLITICAL <br />AUTHORIZATIONS <br />State Or Governmental Agency Or Subdivision Or Political Subdivision: <br />City of Santa Ana Risk Management Division <br />20 Civic Center Plaza, 4th floor <br />Santa Ana, CA 92702 <br />The City of Santa Ana, Risk Management, it's officers, employees, agents, representatives, and volunteers as additional inured. Coverage <br />is primary and not -contributory with respect to insurance or self-insurance maintained by the City. Waiver of Subrogation applies to <br />general liability. Thirty (30) day prior written notice of cancellation required. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II — Who Is An Insured is amended to <br />include as an additional insured any state or <br />governmental agency or subdivision or political <br />subdivision shown in the Schedule, subject to the <br />following provisions: <br />1. This insurance applies only with respect to <br />operations performed by you or on your behalf <br />for which the state or governmental agency or <br />subdivision or political subdivision has issued a <br />permit or authorization. <br />However: <br />a. The insurance afforded to such additional <br />insured only applies to the extent permitted <br />by law; and <br />b. If coverage provided to the additional <br />insured is required by a contract or <br />agreement, the insurance afforded to such <br />additional insured will not be broader than <br />that which you are required by the contract <br />or agreement to provide for such additional <br />insured. <br />CG 20 12 04 13 <br />2. This insurance does not apply to: <br />a. "Bodily injury", "property damage" or <br />"personal and advertising injury" arising out <br />of operations performed for the federal <br />government, state or municipality; or <br />b. "Bodily injury" or "property damage" <br />included within the "products -completed <br />operations hazard". <br />B. With respect to the insurance afforded to these <br />additional insureds, the following is added to <br />Section III — Limits Of Insurance: <br />If coverage provided to the additional insured is <br />required by a contract or agreement, the most we <br />will pay on behalf of the additional insured is the <br />amount of insurance: <br />1. Required by the contract or agreement; or <br />2. Available under the applicable Limits of <br />Insurance shown in the Declarations; <br />whichever is less. <br />This endorsement shall not increase the <br />applicable Limits of Insurance shown in the <br />Declarations. <br />•"�_^`ec Rutk AlD[vlel"` <br />Renexn:o 6 APPROVm Br. <br />Auw.1e <br />1' Risk Management Specialist <br />© Insurance Services Office, Inc., 2012 <br />Page 1 of 1 <br />