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POLICY NUMBER: GLO 3675577 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br />This endorsement modifies insurance provided under the following: <br />COMPREHENSIVE GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization: <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />Re: Encroachment Permits &/or City Licenses for Ken Thompson, Inc. on the <br />Groundwater Replenishment System — Unit I Pipeline Project. <br />(If no entry appears above, information required to complete this endorsement will be shown in <br />the Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or <br />organization shown in the Schedule, but only with respect to liability arising out of "your work" <br />for that insured by or for you. <br />PRIMARY INSURANCE: It is agreed that such insurance as afforded by this <br />policy for the benefit of the additional insured shall be primary insurance as <br />respects any claim, loss or liability arising directly or indirectly from the insured's <br />operations and any other insurance maintained by the additional insured shall be <br />noncontributory with the insurance provided hereunder. <br />CG201011 85 APPROVED AS 'TO FORM <br />- Z/Z. <br />Laura Stitt Sheedy <br />LJLd:�I f�ll:y /{ltOrblA' <br />P'_lf' altlC^l '04 ntr F. ,t <br />