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<br />.!~3.t1l/2003 14:34 FAX _ <br /> <br />. <br /> <br />GOLDEN EAGLE INSURANCE 4IIt <br /> <br />~002 <br /> <br />. <br /> <br />ADomONAL INSURED - OWNERS, LESSEES <br />OR CONTRACTORS (FORM B) <br /> <br />Policy No: CBP9667121 <br /> <br />ADDmONAL INSURED - OWNERS, LESSEES <br />OR CONTRACTORS (FORM B) <br />THIS ENDORSEMENT C.tWIG_~!;JI:l.E! 'p~OU(;Y. PLEASE READ IT CAREFULLY. <br /> <br />POlicy No' CBP9667121 <br /> <br />ThIs endorsement modilles insurance prDVided under the foll....ing: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />WHO IS AN iNSUReD (Section II) is am..nded to jnclude as an Insured the p..rsorl or organization shown In the <br />Schedule, but only with respe,:t to liability arising out of "your worl<" for that Insured by or for you. <br /> <br />The coverage afforded the additional Insu..... does not apply to ilny proje..t on which "your worle" waS completed <br />;;r;;:. ~ thi5 .:?ffi:~~'.,.~:!~ ~!t.i!!~ ~!'!~t)lI"ItRml!nl <br /> <br />~r.:I-IFnUIt= <br />City of Santa Ana, its officers and~employees <br /> <br />CG 20 10 (110115) lo'IodJl\ed <br />GECG 801 (10.e8) <br />