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<br />l"~~r'l": Dana Cable At: Hylant GrallP, Int: FOlxID: Ilylant Grollp To: Carla I-hompkins <br /> <br />POLICY NUMBER PliPK187988 <br /> <br />Date: 10/1312006 03:32 PM I-'age: L of 3 <br /> <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 1007 04 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULL Y. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br /> <br />This endorsement modifioP-s insurance provided under the follovving: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name Of Additional Insured Person(s} <br />Or Organization{s); LocationJ~) Of Covered Operations <br />City of Santa Ana (with respect to <br />Santiago Lawn Bowling C1ubhollSf' <br />at 510 E Memory Lilne) <br />Information reauired to compl~te this Schedule, if not shown above, will be shown in the Declarations <br /> <br />A. Section II - Who Is An Insured is amended to <br />"~\;(~e as an additional insured the pen;on(s) 01 <br />crganization(s) ~Ilown in the Schedule, but only <br />V'Jith respect to liability fOl' "bodily injury". "property <br />damage" or "personal and advel1isin~J injury" <br />caused, in whole or in part, by: <br /> <br />1. Your acts or omissions: or <br /> <br />2. The acts or omissions of those acting on your <br />behan: <br /> <br />in the pertormance of YOllr ongoing opelatiolls for <br />the additional insured(s) at the location(s) deSIg- <br />nated above <br /> <br />..,H____ <br /> <br />B. \^Jitll respecl tu tile illsmance afforded to these <br />additional insllleds, the following additional exclu- <br />sions apply: <br /> <br />This insurance does not apply to "bodily injmy" 01 <br />"property damage" occlllTing after. <br /> <br />1. All Walk, Includin~ materials, parts or equip- <br />ment furnished in connection Witll such work, <br />on the project (other than service. maintenance <br />or repairs) to be performed by or on hoP-half of <br />the additional inslIrcd(s) at the location of tile <br />Gavered opel<itiollS I1ds been completed: 01 <br /> <br />2. That portion of "your work" out of which the <br />injury or damage ,UI""e"" hss been put to its ill <br />tended use by any person 01 01 ~Jdllizatlon <br />other 111dn ,lIlother contractor or subcontractol <br />engageclln performing operations fOl a princi- <br />pal as a part of tile same project. <br /> <br />" <br /> <br />: r;fJ ( <br /> <br />/;, <br /> <br />CG 20 100704 <br /> <br />(Q) ISO Propelties, Inc. 2004 <br /> <br />Page 1 of 1 <br /> <br />o <br />