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<br />O~t 27 05 03:13p <br />OS/2B/2e05 13:~S fAK <br /> <br />Cit~ of Santa Ana PWA <br /> <br />714-847-508S <br /> <br />p.4 <br />fiI 004/005 <br /> <br />l'lAMED INS'UIlBD: Gordoll" W"dIiams lJeneral Contractors IIlC. COMMERCIAL GENERAL UABILlTY <br />l'OLICYNUMBEll: DTC04061B4OSI'ILOS <br />THIS ENDORSEMENT CHANGES THE POUCY. PLEAlSE READ IT CAREFULLY <br /> <br />BLANKET ADDITIONAL INSURED <br />(CONTRACTORS) <br /> <br />ThIS enclorl;ement modifies Insurance provided under .thEl following: <br />COMMeRCIAL GENERAL UABILlTY COVE:RAI3E PART <br />COMMERCIAL GENERAL UABILrrv - CONTRACTORS COVERAGE pAAT <br /> <br />1. WHO IS AN INSURED _ (SocUon II) Is 8IlIended 01 ThIll Insul'll1lCll does not apply \0 'bodily In- <br />w Include any per1lon or ClflIsnlzallon you are re- Jury" or 'propOOy damage' caused by "yuur <br />quired \0 InclUdB as an addlltonallnsUl'll~ on this work" Includod in I"" 'produClts-oornplllted <br />poney by a written contract ar wrilIen ~eement operatlana hazard" unless you are required W <br />in effect dwlng lIlIs pelley petlod and signed and provide such coyel'llge for \he addltionel In- <br />8Xllcuted by you pIlor \0 the loss for which cover- sured by a wriIlen contraot or written 1IGnle- <br />age Is llOughl The pelSOn or organlzaUon does mantln eIfeot during Ihls poloy period and <br />not qualify Ie llIl eddIllonBllnsured W1Ih relpeclln Ilgnecl and e.eoullld by yau prior \0 lilt r_ <br />the Independenlaolll Dr omt"iOl1' of allch plrson for which CDYllI8ge Is fIClUgIlt and lIlen orly <br />or alganlnllon. The psrsan or organization is for the pertod. of IimlI required by such con. <br />only an additional Inlured with respect tD lIab1l1ly tract or agreement and In no evenl beyQnd <br />ceUled by "yuurwor1<" for that addlllonellntured. the expiration data of the polley. <br />2. The InsuranCll provided to ll'le addlllDnal Insured 3. Subpart (1 Ita) of the PalluUon exclusion uncler <br />illlmlted as foUOWO: Paragraph 2., ExdUslOl1I 01 BodIly Injury and <br />a) In tha evenl that the limits 01 liability llIIledln Proptlty Damage Uablllly Covlll'aOe (Section I - <br />\he poUoy exceed the limits of liabllly required Coverages) does not epp'1y W you If the 'bodily <br />by I writlfln conlraCt ar written agreement In Injury" or "property damage" ari$08 out of "yaur <br />effecl during this polley period Ilnc.lllgned snd work' parfonned on premrS18 whlch are owned or <br />enollled by you prior \0 the los8 for which rented by the ac.lditlonallMurtd at the lime "your <br />OOVerllll8 It 10Ught, the InsumlWe pl'O'Jlded work" [a performed. <br />by Ihls eTIdol8llmenl shell be limited In the 4. Arty coverage provided by this endOl'8ament lo an <br />limits oJ lIablllly required by such contracl or sddlllonallnsvred shall bl excess over any other <br />agreemenl ThIs endorsemant shall not In- vRld and collacllbla Insurance avllilabla In the <br />creaselhe Uml\s slated In Seotlon 11I_ LIMITS addltlonallnsurld whether prtmary, _5S, COil- <br />OF INSURANCE. tlngent or on any other basis unlell& a written <br />b) The IneUl3ncsl provided \0 the additional In- contl1l~ or wrlllen agreement In effect during 1hls <br />SUAlc.l does not apply to "bodily InJury". 'prop_ poRoy period and slgnecl and eltecutlld by you <br />erty demslJG', "p.rsonallnJvry" or "advertising prlDr \0 the loss. for which coveragl!l Is toUght <br />Injury" ertslng out of an architect's. englneefs apecUlcBlIy require. that tIlla lnauram:e apply on a <br />or I\lIY.yo~a rendering of or failure to render primll1y or non-contributory basi$. When this In- <br />any profesllonalllervlcss Including: 8urtmce Is primary and thero Is Dth'" Insurance <br />avellable \0 the aCldlllDnel Insured fram any <br />I, The preparlng. approving or falling to souroe. we wllllhsro with thai other Illliura1\C8 by <br />prepare or approve maps, shop drawings, the method dsSQllbed In tile policy, <br />oplnlollll, reports, IUrveyS. field orders, <br />change orders. or drawings and specifl- 5. AI;, a condition of ooverage. eaoh addlllonal <br />OlIUonSi. .nd Insured Must: <br />II. SUp8n1IaOlY or In.pactlon lletlvltlas psr- a.) Give us prOMpt wrlnen nollce of IElnlY "o~a1 - <br />formed al parl of any relaled al'Ohltec:tunsl rence" ar affense which may relul n a.. m <br />or engineering IcllVllles. and prompt written noUes of 'sulf'. <br /> <br />/\Pl'ROV cD AS TO FORT'."~ <br /> <br />CG DZ 4$ 10 02 <br /> <br />COpyrlghl, The Tl8velllt's Indamnlly COmpany, 2002 ~1JJ3!:.s-- Page 1 '" 2 <br /> <br />Laura Stitt sfiCCUY <br />AS:;:lsumt City Attol"ne-:y <br />