CA EMPLOYMENT DEV DEPT 6 - 2007 - Laserfiche WebLink

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c~- G-140331-A99 (Ed. 10/01) IMPORTANT: THIS ENDORSEMENT CONTAINS DUTIES THAT APPLY TO THE ADDITIONAL INSURED IN THE EVENT OF OCCURRENCE, OFFENSE, CLAIM OR SUIT. SEE PARAGRAPH C.1.OF THIS ENDORSEMENT FOR THESE DUTIES. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S SCHEDULED AND BLANKET ADDITIONAL INSURED ENDORSEMENT WITH PRODUCTS -COMPLETED OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy # 2on~o2o3s Eff: 05/06!2007 05/06/08 SCHEDULE Name of Person or Organization: City of Santa Ana Designated Project: The City of Santa Ana, its officers, employees, agents & volunteers shall be named as Additional Insureds) as respects General Liability only per the attached endorsement form G-140331-A99 with respects to Location: Vacant lot @ southeast corner of Walnut Ave. & Bristol St., Santa Ana (APN #008-224-18, 19, 28) (Coverage under this endorsement is not affected by an entry or lack of entry in the Schedule above.) A. WHO IS AN INSURED (Section II) is amended to unless required by the written contract or written include as an insured any person or organization, agreement. including any person or organization shown in the 4. The insurance provided to the additional insured schedule above, (called additional insured) whom does not apply to "bodily injury," "property you are required to add as an additional insured on damage," or "personal and advertising injury'. this policy under a written contract or written arising out of an architect's, engineer's, or agreement; but the written contract or written surveyor's rendering of or failure to render any agreement must be: professional services including: 1. Currently in effect or becoming effective during a. The preparing, approving, or failing to the term of this policy; and prepare or approve maps, shop drawings, 2. Executed prior to the "bodily injury," "property opinions, reports, surveys, field orders, damage," or "personal and advertising injury." change orders or drawings and specifications; and B. The insurance provided to the additional insured is limited as follows: b. Supervisory, or inspection activities pertormed as part of any related 1. That person or organization is an additional architectural or engineering activities. insured solely for liability due to your negligence and specifically resulting from "your work" for C. As respects the coverage provided under this the additional insured which is the subject of the endorsement, SECTION IV - COMMERCIAL written contract or written agreement. No GENERAL LIABILITY CONDITIONS are amended coverage applies to liability resulting from the as follows: sole negligence of the additional insured. 1. The following is added to the Duties In The 2. The Limits of Insurance applicable to the Event of Occurrence, Offense, Claim or Suit additional insured are those specified in the Condition: written contract or written agreement or in the e. An additional insured under this Declarations of this policy, whichever is less. endorsement will as soon as practicable: These Limits of Insurance are inclusive of, and not in addition to, the Limits of Insurance shown 1 Give written notice of an occurrence or in the Declarations. ~t~R an offense to us which may result in a claim or "suit" under this insurance; 3. The coverage provided to the additional insured A~ ~~ by this endorsement and paragraph f. ender the defense and indemnity of definition of "insured con ~'~1~ der any claim or "suit' to us for a loss we DEFINITIONS (Section V) do~lri6[ apply t S.~pRC~~ey cover under this Coverage Part; "bodily injury' or "property damage" arisin E• `,~y Pt~oC (3) Tender the defense and indemnity of of the "products-completed operati az ~ C ~5`Star any claim or "suit" to any other insurer G-140331-A99 Page 1 of 2 (Ed. 10/01)