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POLICY NUMBER: PHPIC624505 COMMERCIAL GENERAL LtAE31LrFY <br />CG 20 lO 0704 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGAN(ZAT(ON <br />This endorsement modifies insurance provided under the following <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Ensured Persan(s) <br />Or Or anization s <br />Locaiion s Of Covered O ations <br />City of Santa Ana - <br />Information re wired to com fete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II —Who Is An Ensured is amended tc B. <br />With respect to the insurance afforded to these <br />include as an additlonal insured the persons} or <br />adtlitlonal insureds, the following additional exclu- <br />organization(s) shown in the Schedule, but only <br />sions apply_ <br />with respect to liability for " bodily Injury', "property <br />damage" or "personal and advertlsing InJury° <br />This insurance does not apply to "bodily injury" or <br />"property <br />caused, in whole or in part, by: <br />damage" occurring after: <br />!. Your acts or omissions; or <br />!. All work, including materials, parts or equip <br />merit furnished in connection with such work, <br />2. The acts or omissions of those acting on your <br />on the project (other than service, maintenance <br />behalf; <br />or repairs} to be performed by or on behalf of <br />in the performance of your ongoing operations for <br />the additional insureds) at the location of the <br />the additional insureds} at the Iocation(s} desig- <br />covered operations has been completed; or <br />Hated above. <br />2. That portion of "your worK' out of which the <br />injury or damage arises has been put [o its in- <br />tended use by any person or organization <br />other than another contractor or subcontractor <br />engaged in performing operations fora princi- <br />pal as a part of the same project. <br />CG 20 1 O O7 04 ®fS0 Properties, Inc., 2004 <br />Page 7 of 1 � <br />