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COMMERCIAL GENERAL LIABILITY <br />POLICY NUMBER: I-660-1430C752-TIL-09 ISSUE DATE: 12-31-08 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -MANAGERS OR LESSORS OF <br />PREMISES <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />1. Designation of Premises (Part Leased to You): <br />2. Name of Person or Organization (Additional Insured): <br />a~_ __ <br />_ _ _-- - _ _ <br />CITY OF SANTA ANA __,_,_..._- <br />20 CIVIC CENTER, 8TH FLOOR <br />SANTA ANA CA 92702 <br />3. Additional Premium: 160 <br />(If no entry appears above, the information required to complete this endorsement will be shown in the Declara- <br />tions as applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to <br />include as an insured the person or organization <br />shown in the Schedule but only with respect to liability <br />arising out of the ownership, maintenance or use of <br />that part of the premises leased to you and shown in <br />the Schedule and subject to the following additional <br />exclusions: <br />This insurance does not apply to: <br />1. Any "occurrence" which takes place after you <br />cease to be a tenant in that premises. <br />2. Structural alterations, new construction or demoli- <br />tion operations performed by or on behalf of the <br />person or organization shown in the Schedule. <br />CG 20 11 01 96 Copyright, Insurance Services Office, Inc., 1994 Page 1 of 1 <br />