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POLICY NUMBER; 1000065722171 <br />COMMERCIAL, GENERAL LIABILITY <br />CG 20 10 07 04 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS SCHEDULE PERSON OR <br />ORGANIZATION <br />This endorsement modifies insuranoe provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Additional Insured Paraon(s) <br />Or Organization(s)I Locatlon(s) Of Covered Operations <br />Andre nresentalvae ' <br />O 0 Center Plaza, M-23 All operations <br />NO <br />Ana CA 927e1 <br />Information required to com late this Schedule, If not shown aAovs, wlll be shown In the Declarations. <br />A. Section II —Who Is An Insured is amended a, <br />to include as an additional Insured the <br />person(s) or organlzatlon(a) shown in the <br />Schedule, but only with respect to liability for <br />"bodily Injury", "property damage", or "personal <br />And advertising Injury" caused, in whole or h, <br />part, by: <br />1. Your acts or omissions; or <br />2. The acKs or omissions of those acting on <br />your behalf, <br />in the performance of your ongoing operations <br />for the additional insured(s) at the locatlon(s; <br />designated above. <br />With respect to the insurance afforded to <br />these additional Insureds, the following <br />additional exclusions apply: <br />This Insurance does not apply to "bodily <br />Injury" or "proparry damage" occurring after: <br />1, All work, including materiata, parts or <br />equipment furnished In conneotlon with <br />soon work, on the prola;t (other than <br />5en9es, maintenance or repairs) to ho <br />performed by or on behalf of the <br />additional Insursd(a) at the location of the <br />covered Operations has been completed; <br />or <br />2. That portion of 'your work' out oF01ch <br />the Injury or damage arisas has been put <br />to its intended tree by any person or <br />organization other than another <br />contractor or subcontractor engaged in <br />performing operations for a principal as a <br />part of the same project. <br />�g\�G��d� /a <br />v <br />�a�°d�;��' <br />CG 20 10 07 04 0 180 Properties, ino„ 2004 <br />J3180332 I atltane" 1 17 "TIC, 17-10 tl4 L-W-CPL4L I aharey mm I tah¢nan 9136n, nn :cCn I e"en ¢ a, , <br />Page 1 of 1 <br />