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<br />JUl 16 '05 14:19 fROM: <br /> <br />T-146 P 43/44 f-070 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL II\1SURED - OWNERS. LESSEES OR CONTRACTORS <br />ITENDER OF ANY LOSS TO OTHER AVAILABLE INSURANCE, AND EXCLUSION OF EMPLOYEE INJURY) <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE FORM <br /> <br />This endorsement changes the policy effective on the inception date of the policy unless another date is <br />indicated below. <br />Endorsement Effective <br />Attached to and forming a part of Policv (Standard Time) Endor3C1mant Number <br />Number mm I dd I yy I 12:011 A.M. <br />1506003228 05/l~/~005 <br />(The above information is require,j only when this endorsement is issued subsequent to proparatlon of the policy.) <br /> <br />Authorized ReDresentative <br /> <br />Date <br /> <br />Name of Person Or Organization: <br />CITY OF SANTA ANA <br /> <br />SCHEDULE <br /> <br />APPROVLU A:-; TO H),CVJ <br /> <br />20 CIVIC CENTER PLAZA, RM 97 <br />SANTA ANA, CA 92701 <br /> <br />This endorsemenr is provided in consideratio" of an additional pr.mium. <br /> <br />tj(~~~1~---I!f __ <br />, l.:!L:LI ,:,/,\;)::'~d}' <br />,\:,:,l:)L"ll \,.,: \, ,~:'.... <br /> <br />Premium: <br /> <br />100 <br /> <br />E;<posure: Only the person or organization named <br /> <br />ClassilicationCode: 49950 <br /> <br />Who Is An Insured (Section III is amended to <br />include as an insured the person or organization <br />shown in the SCHEDULE, but only with respect <br />to liability arising out of your ongoing operations <br />performsd lor that insured. including acts or <br />omissions of the Additional Insured in connection <br />with the general supervision of such op.ratiorUI, <br /> <br />Except as provided above, this insurance does <br />not apply to any "bodily injury.. "property <br />damage" or "penonal and advertising injury" <br />ari8ing out of or resulting from the neglect or <br />negligence of ths Additional Insured described in <br />thi15 endorsemenT. <br /> <br />The company willhava no duty to defend any .suit" <br />which all ages neglect or negligence of the <br />Additionsllnsured. <br /> <br />If other valid and collsctible in,urance is available <br />to thG person or orgQnlZQtlon 5hown In the <br />SCHEDULE for a loss we cover under Coverage A <br />or B of the Covl!lrllge Form 10 which this <br />endorsement attaches. then the person or <br />orSlIniunion shown must also tender any loss to <br />each such other jnsuranc8. Should such other <br />in9urance apply, then this insurance is eXce9S <br />aver any other such insurance. <br /> <br />8G.G-370 0603 <br /> <br />I. <br /> <br />This insurance does not apply to any "bodily <br />injurv" to: <br /> <br />a. An "employee" of any insured, or a <br />person hired to do work for or on bahalf <br />of any insursd or a tenant of any insured. <br />that arises out of and in the course of: <br /> <br />(1 I Employment by any insured; or <br /> <br />121 Performing duties relatad to the <br />oonduct of any in3ured':J; bU5iness; or <br /> <br />b. The spouse, child, parent. brother or <br />sister of that "employee" as a con- <br />sequence of Paragraph a. above. <br /> <br />This exclusion applies: <br /> <br />a. Whether an insured may be liable a. an <br />om pi oyer or in any other c<l:Ipacity; and <br /> <br />b. To any obligation to share damages with <br />or repay SOmeone else who must pay <br />damages because of the inJurv. <br /> <br />These provisions and exclusions apply in addition <br />to those contained in the Coverage Form. All of <br />the provIsions and axclusions of the policy that <br />apply to L1ABILllY COVERAGES also apply to <br />this endorsement. <br /> <br />Page 1 of 1 <br />