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09/10/2014 13:02 9516650665 LOOMIS INSURANCE PAGE 03/03 <br />e <br />I <br />POLICY NUMBER: 'vR 220969 COMMERCIAL 43ENERAL LIABILITY <br />CO 20 1907 04 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modifies Insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEOULE <br />Name of-Additional insured Persons) <br />Or Organlaation(s): <br />Location(&) Of Covered Operations <br />varzoue <br />nie City Of Santa. Ana <br />PO Sox 1.988 <br />&Mta Ana, Ca 92702 <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 inciudn <br />as an additional „insured the paraon(s) or <br />organization(s) shown in the Schedule, but only with <br />respect to liability for 'bodily injury," "property <br />damage" or "personal and advertising Injury" caused, <br />In whole or in part, by; <br />1. Your acts or ominnidn8; or <br />2. The acts or omissions of those noting on your <br />behalf; <br />in the performance of your ongoing operations for the <br />additional Insurad(s) at the locatlon(s) designated <br />above. <br />B. With respect to the insurance afforded to these <br />additional Insureds, the following additional <br />exclusions apply; <br />This Insurance does not apply to 'bodily Injury" or <br />"property damage" occurring after <br />1. All work, including materials, parts or equipment <br />furnished In connection with such work, on the <br />project (other than service, malManance or <br />repairs) to be performed by or an behalf of the <br />additional Inoured(e) at the location of the covered <br />operetions has been completed; or <br />2. That portion of "your work" cut of which the Injury <br />or damage arises has been put to its intended use <br />by any person or organization other than another <br />contractor or subcontractor engaged In <br />performing operations for a principal as a part of <br />the same project. <br />APPROVED AS TO FORNYL <br />�1W "Laura A. Rossini <br />Assistant City Attorney <br />cc 20 10 07 04 Gopynght, ISO Propertles, Inc., 2004 page 1 or t <br />