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<br />Sep 06 05 02:21p <br /> <br />Public Works <br /> <br />Yard <br /> <br />714-647-3342 <br /> <br />tAil 11, 2005 9. 34AM <br /> <br />HP LASERJET 3200 <br />AMERiCAN f&S-SF 4IS-19B-!7l0 <br /> <br />P. 4 <br /> <br />JAN 31 2005 2:13PM <br /> <br />NO.ns! <br /> <br />COMMEAOlAlGeNEIlAL LlAIIIllTY <br />CO 10 10 0?04 <br />THIS ENDORSEMENT CHANGES THE POlICY. PlEASE READ ITCAREFULL Y. <br /> <br />POUCYNUIJIBER: CIoSI04lH6 <br /> <br />ADDITIONAL INSURED. OWNERS. LESSEES OR <br />OONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br /> <br />COMMERCIAl GENERAL UAlJILnY COVERAGI! PART <br /> <br />Thill endorsement modllles 1Il.lllan~. prDIIIll8d lIlIder the following: <br /> <br />SCHEDULE <br /> <br />N.m. 01 AdcRIaMl.....lPWd PIl'Ion(e) <br />OrOdanlZallorii&l . <br /> <br />ern' os SNlTA ANA <br />~ 0 C!VI C C1lNTItR PLAU <br />SANT ANA, CA ~27Cl <br /> <br />.. <br /> <br />of Oov.rsl 08-'<lno <br /> <br />Infomle\Ion reaUiI1ld to CQmr:dele ttis SchelUe, .1IOl ~ lIbOVtl, WIIIIle ._In the Dec:larotions. <br /> <br />A. Sectio.". Wh"l. An '.IU"",, i. ameMed to I.- <br />c1ude iii an llddilloret iNUI'lld !till peROn(l) or 01. <br />-~-b""_.(,) ohown In the ScheCllfe. btJt only with <br />1'I;;~~1 UJ ,rjb_lty ior '"bcdlly iV! ~~'! ~t!m <br />aglror'PIJ(f;Qn;II and adYlllIl8i,... :;~c., ...;~cc. ,.. <br />whole or In part by. <br />1. VntJr f!'1~~ orom"'iooB' fW <br /> <br />~. iiili iii:;-';i Oi Vroitiiji:;nre Ui ihYK Q.~~iV 1tiI1' VWt <br />bMalf. <br /> <br />III U"' "'~IVII''l1If_V'.'~w vt~"'~_':::=__::.....__._ __._ <br />,hit addlUorellnliUftCJll;Sf I.. the ,-"-"",><"",, -;;;;;;.Zf <br />nlled above. <br /> <br />B. Wab reopeclla lbl inSUl'Ilnce !Il\Ol'd1~ 10 lhe8e ad- <br />dltlonel ""lAdl, tile lO/IOWing lIdd~ional exclu- <br />llo",."p1y: <br /> <br />-property"amagl' accurnng entr. <br />1. All wark, Inc/udl/lg meteria... parts or oq~- <br />"'''''' f~mi.hed 1<1 cannecllan with such work, <br />on the pt*~ :....l-_a ...... ..... .1-... _...1...- <br />"~rll'~ f'!II' ~~~.... 01.. ...............-...J VI VI' "'"Sr. <br />=<l<lhlonel n..-"",.l III "'. location <br /> <br />pleled;Ot <br /> <br />2. That parllon of "yDu. work. out of whiCh tile ir. <br />IlIIY or damage IlIl8IB hili blBn put 1ll IrB <br />l-.:lecl use by any plIJaOn or ""ii"':"='-'- <br />~.,.. .,,"~ 4Mlber COlIllactar anubconu"""" <br />~ 1....iinoI ~ij pel'formtng opere:~tL-!'I'! 1.:01' ~ rri"~i. <br />p81n a pall of Ibl oame p1ej..;;, <br /> <br />Page 1 of I <br /> <br />co 20 10070. CllIll/Ilofl, ISOPl'opalIIel\ 1nc.,2004 <br />I".lJllBD <br />. "l)";:,u A.S 'fO FORM <br />--' ~Sl:'{~dY <br /> <br />h .~ls[alU City Attorney <br /> <br />p.3 <br /> <br />p.2 <br /> <br />I <br />