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71 A4i30fi52q Flh1TF.:H Havahx Survi <br />13 32 ,1 CC, 12 2001 212 <br />Policy Number: 02 CSE T10004 Effective Data: 04101/2007 ' <br />Named Insured and Address: UNITED TECHNOLOGIES CORPORATION <br />ONE FINANCIAL PLAZA <br />HARTFORD, CT 06101 <br />Endt. No <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY INSURANCE POLICY <br />SCHEDULE <br />Name of Person or Organization: CONTRACT NO' DVB -06416 <br />CITY OF SANTA ANA, ITS OFFICERS, EMPLOYEES, AGENTS, VOLUNTEERS AND REPRESENTATIVES <br />WHO IS AN INSURED (Section ll} is amended to include as an insured the person or organization shown in the <br />Schedule, but only with respect to liability arising out of "your work' for that insured by or for you. <br />For the purpose of the endorsement, "you' shall refer to Otis Elevator Company d/bla Amtech Elevator Services, <br />and "your work" shall mean work performed by or for Otis Elevator Company dfb /a Amtech Elevator Services. <br />\. -i ROVEIJI AS TO FORM <br />� <br />'.?r <br />�- :aa:;1t City - vtorscv <br />Form GT 53 2413 (ED 01 /03) <br />® 2003, The Hartford <br />(Includes copyrighted material of Insurance Services Office <br />with its penniseon. Copyright, Insurance Services Office, Inc, 2003 ) <br />Page 1 of 1 <br />