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UC(.2J. 2006 11:56W L A K t 1NSURANGt AGLN(,Y <br />No. U!41 r. 5 <br />POLICYNUMBER SCP061B371 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 10 07 04 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modes Insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Additional Insured Person(s) <br />Or O enlzatlon s Locations of Covered Operations <br />city of Santa Ana 2215 N. Broadway <br />P.O- Box 1968 Santa Ana, CA 92705 <br />Santa Ana, CA 92702 <br />Irdormation required to complete this Schedule. If not shown above, will be shown in the Declarations. <br />A. Section 11 - Who Is An Insured Is amended to in- <br />clude as an additional Insured the person(s) or or- <br />ganl2atlon(s) shown in the Schedule, but only with <br />respect to liability for °bodily fnjury', "property dam- <br />age' or "personal and advertising injury' caused, in <br />whole or in part, by: <br />1. Your acts or omissions; or <br />2- The acts or omissions of those acting on your <br />behalf; <br />In the performance of your ongoing operations for <br />the additional insured(s) at the location(s) desig- <br />nated above. <br />s. With respect to the insurance afforded to these ad- <br />ditional insureds, the following additiotrai exclu- <br />sions apply: <br />This insurance does not apply to 'bodily injury" or <br />"property damage" occurring after: <br />1. All work, including materials, parts or equip- <br />ment furnished in connection with such work, <br />on the project (other than service, mainte- <br />nance or repairs) to be performed by or on be- <br />half of the additional insured(s) at the location <br />of the covered operations has been com- <br />pleted; or <br />2. That portion ct -your work" out of which the In- <br />jury or damage arises has been putt to its <br />Intended use by any person or organization <br />other than another contractor or subcontractor <br />engaged in performing operations for a princi- <br />pal as a part of the same project. <br />CG 2010 07 04 Copyright, ISO Properties, Inc., 2004 Pagel of 1 <br />INSURED <br />