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POLICY NUMBER: L13 M074308 00 COMMERCIAL GENERAL LIABILITY
<br /> CG 20 12 12 19
<br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
<br /> ADDITIONAL INSURED - STATE OR GOVERNMENTAL
<br /> AGENCY OR SUBDIVISION OR POLITICAL
<br /> SUBDIVISION - PERMITS OR AUTHORIZATIONS
<br /> This endorsement modifies insurance provided under the following:
<br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART
<br /> SCHEDULE
<br /> State Or Governmental Agency Or Subdivision Or Political Subdivision:
<br /> 1. City Of Downey And Their Agents,Officers And Employees,
<br /> Attn: Engineering Division, Po Box 7016 Downey,CA 90241-7016
<br /> 2. The City Of Huntington Beach, Its Officers, Elected Or Appointed Officials,Employees,Agents And Volunteers 2000 Main Place,Huntington
<br /> Beach,CA 92648
<br /> 3. City Of Santa Ana Risk Management Division 20 Civic Center Plaza,4th Floor,Santa Ana,CA 92702,City Of Santa Ana,Risk
<br /> Management, It's Officers,Employees,Agents,Representatives,And Volunteers
<br /> 4. The County Of Los Angeles And Public Entity Or Special District For Which The Los Angeles County Board Of Supervisors Is The
<br /> Governing Body,And Their Agents Officers And Employees
<br /> 5. County Of Orange Row Permits,P.O.Box 4048,Santa Ana,CA 92702-4048
<br /> 6. The City Of Long Beach, It's Boards And Commissions,And Their Officials,Employees,And Agents City Of Long Beach Department Of
<br /> Public Works, Project Management Division,411 W.Ocean Blvd,5th Floor,City Hall,Long Beach,CA 90802
<br /> 7. The County Of Los Angeles And Public Entity Or Special District For Which The Los Angeles County Board Of Supervisors Is The
<br /> Governing Body,And Their Agents,Officers And Employees,Shall Be Additional Insured(s)While Acting Within The Scope Of Their Duties
<br /> Against All Claims Arising Out Of Or In Connection With The Work To Be Performed Department Of Public Works/Land Development
<br /> Division,Po Box 1460,Alhambra,CA 91802-1460
<br /> 8. The City Of El Cajon(And/Or The Successor Agency To The El Cajon Redevelopment Agency),And Its(Their)Elected And Appointed
<br /> Officials,Officers,Employees And Volunteers(For Purposes Of This Policy,Individually And Collectively,The("City Insured")As Additional
<br /> Insureds.
<br /> Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
<br /> CG 20 12 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2
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