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POLICY NUMBER: 6BRPG0000005627000 <br />COMMERCIAL GENERAL LIABILITY <br />CO 20 11 0413 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />rrA r 11 s <br />061mel * « . <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />1. Designation of Premises (Part Leased to You): <br />Premises as described in the agreement or lease <br />Ref: LaVern Davis <br />2. Name of Person(s) or Organization(s) (Additional Insured): <br />The City of Santa Ana and it's officers, employees, agents and representatives <br />Ref: CP# 1203 <br />Attn: Carmen Acosta <br />1825 W. Civic Center <br />Effective: 06/08/14 to <br />Santa Ana, CA 92701 <br />06/08/15 <br />3. Additional Premium: None <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 arising out of the <br />ownership, maintenance or use of that part of the <br />premises leased to you and shown in the <br />Schedule and subject to the following additional <br />exclusions: <br />This insurance does not apply to <br />1. Any "occurrence" which takes place after you <br />cease to be a tenant in that premises. <br />2. Structural alterations, new construction or <br />demolition operations performed by or on <br />behalf of the person(s) or organization(s) <br />shown in the Schedule. <br />However: <br />The insurance afforded to such additional <br />insured only applies to the extent permitted <br />by law; and <br />2. If coverage provided to the additional insured is <br />required by a contract or agreement, the <br />insurance afforded to such additional insured will <br />not be broader than that which you are required <br />by the contract or agreement to provide for such <br />additional insured. <br />B. With respect to the insurance afforded to these <br />additional insureds, the following is added to Section <br />III — Limits Of Insurance: <br />If coverage provided to the additional insured is <br />required by a contract or agreement, the most we will <br />pay on behalf of the additional insured is the amount <br />ofinsurance: <br />1. Required by the contract or agreement; or <br />2. Available under the applicable Limits of Insurance <br />shown in the Declarations; <br />whichever is less. <br />This endorsement shall not increase the applicable <br />Limits of Insurance shown in the Declarations, <br />00 2011 0413 0Insurance Services Office, Inc., 2012 <br />APPROVED AS TO FORM <br />STTOR <br />Assistant City Attorney <br />L�I Page 1 of 1 <br />