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<br />COMMERCIAL GENERAL LIABILITY CG 20 10 07 04 <br />POLICY NUMBER: CBP8932329 Effective Date: 12/01/2012 <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) <br />or Organ Izations : <br />Location(s of Covered Operations <br />City of Santa Ana, City of Santa Ana Acting as <br />Successor Agency and/or Housing Authority of <br />the City of Santa Ana, its officers, employees, <br />agents, volunteers and representatives <br />It is understood and agreed that this Insurance <br />is primary and any other insurance <br />maintained by the Additional Insured shall be <br />excess only and not contributing with <br />this Insurance in regards to all operations as <br />pertains to the named insured <br />information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section 11 - 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", "property <br />damage" or "personal and advertising injury" <br />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 />in the performance of your ongoing operations for <br />the additional insured(s) at the location(s) desig- <br />nated above. <br />B. With respect to the insurance afforded to these <br />additional insureds, the following additional exclu- <br />sions apply: <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring after: <br />1. All work, including materials, parts or equip- <br />ment furnished in connection with such work, <br />on the project (other than service, <br />maintenance or repairs) to be performed by or <br />on behalf of the additional insured(s) at the <br />location of the covered operations has been <br />completed; or <br />2. That portion of "your work" out of which the <br />injury or damage arises has been put to its in- <br />tended use by any person or organization <br />other than another contractor or subcontractor <br />engaged in performing operations for a princi- <br />pal as a part of the same project. ? o <br />C 1? <br />CG 20 10 07 04 <br />© ISO Properties, Inc., 2004 <br />0,j P r,.. <br />4*W <br />A4 S.\ OG <br />P c?e,?tn\?1 ? <br />3I4