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POLICY NUMBER: <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 10 04 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -OWNERS, LESSEES OR <br />CONTRACTORS -SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) Or Organization(s): <br />City of Santa Ana <br />20 Civic Center Plaza <br />SANTA ANA, CA 92701 <br />Location(s) Of Covered Operations <br />All Locations <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 the person(s) <br />or organization(s) shown in the Schedule, but <br />only with respect to liability for "bodily in- <br />jury", "property damage" or "personal and <br />advertising injury" caused, in whole or in <br />part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of those acting on <br />your behalf; <br />in the performance of your ongoing oper- <br />ations for the additional insured(s) at the to- <br />cation(s) designated above. <br />However: <br />1. The insurance afforded to such additional <br />insured only applies to the extent permit- <br />ted by law; and <br />2. If coverage provided to the additional in- <br />sured is required by a contract or agree- <br />ment, the insurance afforded to such <br />additional insured will not be broader <br />than that which you are required by the <br />contract or agreement to provide for such <br />additional insured. <br />B. With respect to the insurance afforded to <br />these additional insureds, the following addi- <br />tional exclusions apply: <br />This insurance does not apply to "bodily in- <br />jury" or" property damage" occurring after: <br />1. All work, including materials, parts or <br />equipment furnished in connection with <br />such work, on the project (other than ser- <br />vice, maintenance or repairs) to be per- <br />formed by or on behalf of the additional <br />insured(s) at the location of the covered <br />operations has been completed; or <br />2. That portion of "your work" out of which <br />the injury or damage arises has been put <br />to its intended use by any person or or- <br />ganization other than another contractor <br />or subcontractor engaged in performing <br />operations for a principal as a part of the <br />same project. <br />Risk Mm ogemmtDMabn <br />REMEWED 6 APPROVED BY: <br />A� Aewed� <br />Risk Management Spetlahst <br />CG 20 10 04 13 © Insurance Services Office, Inc., 2012 <br />Page 1 of 2 <br />