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<br /> <br /> <br /> <br /> POLICY NUMBER: 660 456L636o 09 COMMERCIAL GENERAL LIABILITY <br /> PHSM3si22s CG 20 37 10 01 <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 /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name of Person or Organization: <br /> CITY OF SANTA ANA, COMMUNITY DEVELOPMENT AGENCY <br /> <br /> Location And Description of Completed Operations: <br /> LABOR MONITORING SYSTEMS <br /> Additional Premium: <br /> NA <br /> <br /> (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as <br /> applicable to this endorsement.) <br /> Section II - Who Is An Insured is amended to include. as an insured the person or organization shown in the <br /> Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the <br /> schedule of this endorsement performed for that insured and included in the "products-completed operations haz- <br /> ard". <br /> AS TO FORD <br /> ~pROV£D <br /> S~ ORCK <br /> l1SA E ity p~ttor"ey <br /> p,ss~stant C <br /> <br /> CG 20 37 10 01 © ISO Properties, Inc., 2000 Page 1 of 1 <br />