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POLICY NUMBER: 13 ces oA90z1 <br />THIS ENDORSEMENT CHANC3ES THE POLICY, PLEASE READ IT CAREFULLY. <br />A®®IT'1®A?AI?. IASSUR?fJ ?Y COIVT?tA?C7 ®f? AGR?EfVl?lil`f" m <br />®P?'I®Pd 111 <br />This endorsement modlFies Insurance provtded under the tollo?ving: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) <br />Or Or antzatlon s : Designated Project(s) or Location(s) <br />Of Covered O erattons <br />The City of Santa Ana, its oE£icara, <br />employees, agents and representative <br />20 Civic Centex Plaza <br />Santa Ana, CA 92701 <br />Information re ulred fo com fete this Schedule If not shown above will be shown In the Declarations. <br />A. Section 11 -Who la An Insured is emended to <br />include es an addltlonal Insured the person(s) or <br />organlzatlon(s) si?o?vn In the Schedule above wilfi <br />wham you agreed In a written contract or v?rliten <br />agreement fo provtda insurance such as Is <br />afforded under lhfs policy, but only to the eMent <br />- that such person or organlzallon 1s liable (or <br />"bodily lnJury", "properly damage" or "personal <br />and adve?tisiny InJuiy" caused by your acts or <br />omisslons or the acts or omisslons of Ihose acting <br />on your behalL• _ <br />1. !n the performance of your ongoing operations <br />for such addltlonal insured at the projects} or <br />location(s) designated In the Schedule; <br />2, In connection v?ith your premises owned by or <br />rented to you and shown 1n the Scliadute; or <br />3. !n connection with "your work" for fife <br />addltlonal Insured at the project(s) or <br />fooation(s) deaignaled In the Schedule and <br />Included wilhtn the "products-completed <br />operations hazard", but only If: <br />a. The wrllten conlracf or agreement <br />requires you to provide such coverage to <br />such addl[fona[ Ensured at the project(s) or <br />location(s) desfgnaled In the Schedule; <br />and <br />b. This Coverage Part provides coverage for <br />"bodily lnJury" or "properly damage" <br />Included wilhth the "products-completed <br />operations hazard". <br />B. The Insurance afforded to these additional <br />Insureds applies only ff the "bodily lnJury" or <br />"property damage" occurs, or the "personal and <br />advertising lnJury" offense Is committed: <br />1. During the policy period; and <br />2. Subsequent to the execution of ouch wrillen <br />contract or wrillen agreement: and <br />3. Prior to Iha expiration of the pericd of Ilrne that <br />the wrillen contract or wrllten agreement <br />requires such Insurance be provtded to the <br />additional Insured. <br />Form HS 24 82 08 08 <br />Pegs 1 of 3 <br />© 2008, The Hartford ?®.?? <br />(Includes copyrighted matarlai of Insurance Services Office, Inc. ?vilh its permission.) RS T? ? <br />RCK <br />Exhibit C p,$slstar? d(/ f.?