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POLICY NUMBER: 711-01-13-30-0001 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) Or Organization(s): <br />THE CITY OF SANTA ANA <br />20 CIVIC CENTER PLZ # M-30, P 0 BOX 1988 <br />SANTA ANA, CA 92701-4058 <br />Location(s) Of Covered Operations: <br />Location Building <br />1 1 * THIER RESPECTIVE OFFICERS, EMPLOYEES, <br />AGENTS, VOLUNTEERS AND REPRESECTATIVES <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II — 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 <br />with respect to liability. for "bodily injury", <br />"property damage" or "personal and advertising <br />injury' caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of those acting on your <br />behalf; <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring after: <br />1. All work, including materials, parts or <br />equipment furnished in connection with such <br />work, on the project (other than service, <br />maintenance or repairs) to be performed by <br />or on behalf of the additional insured(s) at the <br />location of the covered operations has been <br />completed; or <br />in the performance of your ongoing operations for 2. That portion of "your work" out of which the <br />the additional insured(s) at the locations) desig- injury or damage arises has been put to its <br />nated above. intended use by any person or organization <br />other than another contractor or sub- <br />B. With respect to the insurance afforded to these contractor engaged in performing operations <br />additional insureds, the following additional exclu- for a principal as a part of the same project. <br />sions apply: <br />CG 20 10 07 04 © ISO Properties, Inc., 2004 Pagel of 1 <br />INSURED <br />