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(:: POLICY NUMBER: PPS 05312 733 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 to 07 of <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 cndorscnsnt modifies insurance provided under the folloviag: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Named Of Additional Insured Persons) <br />Or Organizations <br />Location(s) of Covered Operations <br />City of Santa Ana <br />Information required to complete the Schedule, if not shown above. will be shorn in the Declmmtioas. <br />A. Section H - Who is .An Insured is amended to <br />include as an additional insured the person(s) or <br />orgnizatioo(s) sholm is the Schedule, but only with <br />respect to liability far "bodily igiutp". "property <br />damage' or "personol and advertising injury" caused_ <br />in whole or in part, by: <br />1. Your acre or rnnissions; or <br />2. The nets or omissions of those acting on <br />your behalf: <br />in the performance of your outgoing operations for <br />the additional insured(s) it the locatioa(s) designated <br />above. <br />CG 20 10 07 04 <br />B. With respect to the insurance afforded to these <br />additional insureds, the folloviug additional <br />exclusions apply: <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring after: <br />I. All work, including ninterials, parts or equipment <br />firuished in connection with such work, on the <br />project(otherthan service, ntaiatcnance or repairs) <br />to be performed by or on behalf of the additional <br />insured(s) at the location of the covered ope(atimts <br />has been completed: or <br />2. That portion of `your work" out of which the <br />injury or damage arises has been put to its <br />intended use by my person or organization other <br />t1mo mtodwr contractor or subcontractor engaged <br />io performing operations for a principal as a part <br />of the same project. <br />Copyright ISO Properties, Inc._ 2004 <br />CERT NO.; 21158622 CLIENT COOS; TOWNP110L C1ariNaa Kim 9/3/2014 11:19:54 RM (PDT) Page 2 of 2 <br />Page 1 of 1 <br />