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<br />Dee 02 02 12:481" <br />u..e 02 02 12: lOp <br /> <br />PRCSA <br /> <br />5714211 <br />7145268380 <br /> <br />1".3 <br /> <br />1".3 <br /> <br />POUCY NUMBER GC047286 <br /> <br />THIS ENDORHMENT CHANGES THE POUCY. Pll"ASE READ IT CAREFullY. <br /> <br />COMMERaAl GENERAl UABIUlY <br />a; 20 10 1001 <br /> <br />ADDmONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANlZAnoN <br /> <br />ThiS endorsement modifies illSu'ance llI'ovided under the following; <br /> <br />COMMERClAL Gl::NERAL UAB1UlV COVERAGE PART <br />SCHEDULE <br /> <br />Name of....M4or OrIaIIilratioll: <br /> <br />CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, <br />AGENTS, VOLUNTEERS, AND REPRESENTATIVES <br />20 ClVIC CENTER PlAZA <br />SANTA ANA, CA 92701 <br /> <br />(If no entry """".....~ -...tJon r~ lo eompIete lIIis "-""rnent wil be shown In the Oedaratlons as allllllcable <br />tolt1..~) <br /> <br />A. ...... D -WJtl) ISM ~ i< amended <br />10 incble as an InSUred the person Co <br />organizadon """"" In t!leSCt\e(1ule, but only <br />willi ,espett b lability ariSinfl.... 01 roor <br />ongoi>g operations petforme<llbr !hat instred. <br /> <br />(1) AllWOrk, including _, parts a <br />eqooipmert Unfshed in aJnflocl1on with <br />SUCIl_k, on the poojett (oll1et I",", <br />service, maillenance a repalrs) 10 be <br />Il"Ifonnod by... on belloW Of the addition.1 <br />ill!itJNCl(S) at Ihl> Site otlhe ~ <br />~ has '-' <Ilnlp/eted; or <br /> <br />I. With respoa It> tile Insutanoe .I!brcled II> these <br />addltionall~, the ~eo:llsion Is <br />adclecl: <br /> <br />This ~ does !lOt"I'P1v II> "bodIIv <br />inJIlty'" or "pq>erty damage" 0CLUrr1ng aIler: <br /> <br />(2) That pottioa of'~ -..- 0Ilt of W/lk:h Ihe <br />Injlxy or damage arises has been ~ut to Is <br />Inb:ncIecI us. by any _ Or CJIIO<lJza/lon <br />--anoIhorconb..:l>1r a S<b:oIolla..to, <br />etIgagB:Iln Jl8fanning ~ lbr if <br />~asap;rtof~5ame/l'OJllct. <br /> <br />2. -- . . I~ <br /> <br />~//1, <br />--- . ., <br />..',. ILL <br />, / .1ii:L.7''....---....--...-... <br />i/' ,," ,dS <br /> <br />~<,. \ (} I:: i <br /> <br />,\ r"fl!,:\ <br /> <br />CG 2ll1O lD D1 <br /> <br />JSO~1IIc., 2IIOD <br /> <br />~lof1 <br />