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POLICY NUMBER: 72SBAIT8387 <br /> it <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - COMPLETED OPERATIONS <br /> This endorsement modifies insurance provided under the following; <br /> BUSINESS LIABILITY COVERAGE FORM <br /> SCHEDULE <br /> Name Of Additional Insured Person(s)Or Organization(s): <br /> City of Santa Ana, its City Council, officers, officials, employees, agents and volunteers <br /> Location And Description Of Completed Operations: <br /> 20 Civic Center Plaza, Santa Ana CA 92701 <br /> Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> Section C. — Who Is An Insured is amended to <br /> include as an additional insured the person(s) or <br /> organization(s) shown in the Schedule, but only with <br /> respect to liability for "bodily injury" or "property <br /> damage" caused, in whole or in part, by "your work" <br /> at the location designated and described in the <br /> schedule of this endorsement performed for that <br /> additional insured and included in the "products- <br /> completed operations hazard". <br /> i <br /> i <br /> I <br /> Form SS 41 71 06 11 Page 1 of 1 <br /> © 2011,The Hartford <br /> (Includes copyrighted material of Insurance Services Office, Inc., with its permission) <br />