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2100 - FS Contractors, Inc. - Jay Imperial Park Crosswalk Installation and Sidewalk Replacement Project - ARCHIVEA This page is part of your document - DO NOT DISCARD of tOs 20230452254 ��� � ��"�t II I IIII I III I Illllll I II III II I Illllll flaB1 � + Recorded/Filed in Official Records t 4 Recorder's Office, Los Angeles County, t t California 07/11/23 AT 12:46PM A Pages:0004 FEES: 0.00 TAXES: 0.00 OTBER: 0.00 cm Li inr PAID: 0.00 IIIIIIIYVIInIIItlIIIIIINIIIINIIIIIII�VIIIIIIVIIIIIIII LEADSHEET 1111111111111111111111111111111111111111111111111111111111111 202307112910004 00023590112 IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII 014161353 SEQ: 01 DAR - Mail (Intake) IIIIII IIIIII IIII IIIIII IIII IIIIII IIII IIIIII III IIIIII IIIII IIIII IIIIII III IIIIII IIIII IIIII IIIII IIII IIII IIIIII Illllll IIIII IIIII IIII IIII IIIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIIII IIII IIIIII IIIII III IIII - THIS FORM IS NOT TO BE DUPLICATED - EW211 RECORDING REQUESTED BY CITY OF ROSEMEAD AND WHEN RECORDED MAIL TO: Name City of Rosemead Street Address 8838 E. Valley Blvd. City & State Rosemead, CA 91770 ATTN: CITY CLERK Notice is hereby given that: 23590112 IIIIIIII�III'111111'VIII'�illllllilill'Il�illllllll Batch Number: 14161353 llllll lilil llll' f l�I 11 lli IIIiI �!''li lllll!ul'lP SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full name of the undersigned is: 3. The full address of the undersigned is: of Rosemead 8838 E. Valley Blvd., Rosemead, CA 91770 4. The nature of the title of the undersigned is: In fee (If other than fee, strike "In fee" and insert, for example, "purchaser under contract of purchase", or "lessee") 5. The full names and full addresses of all persons, if any, who hold title with the undersigned are: Names Addresses N/A N/A 6. The names of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the work of improvement herein referred to: Names Addresses N/A N/A IA] 7. A work of improvement on the property hereinafter described was completed on: May 24, 2023 8. The name of the contractor, if any for such work of improvement was: FS Contractors, Inc. 9. The property on which said work of improvement was completed is in the City of Rosemead County of Los Angeles , State of California, and is described as follows: Sidewalk Gap Closure - Delta Avenue from Mission Drive to Wells Street Project 10. The street address of said property is: as listed in No. 9 jif no street address has been otticially assigned, insert "none" Signature of Z owner named Dated: in paragraph 2: Ben rim City Manager By: City of Rosemead I certify (or declare) under penalty of perjury that the foregoing is true and correct. Date Rosemead, CA Place of Execution Ben Kim City Mana City of Rosemead, California CALIFORNIA ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California 1Pr;1 County of �nlNV1QJ On lu 3t W�3 before me, ! Nowt Date Here Insert Name and Title of the Officer personally appeared of who proved to me on the basis of satisfactory evidence to be the person(y6vhose name isAam-subscribed to the within instrument and acknowledged to me that hehh ftMTexecuted the same in hisiherftttefl— authorized capacity, and that by hisA+el7R12ft signature' on the instrument the person �j, or the entity upon behalf of which the person(Yacted, executed the instrument. NATALIE HAWORTH Notary Public - California [f Los Anoft County 9 Commission r 2427955 My Comm. Expires Dec 20, 2624 Place Notary Seal and/or Stamp Above I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature o otary Public Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Title or Type of Docurrter Document Date: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer is Representing: 02019 National Notary Association 6\tovl' _ Number of Pages: 21 Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner— ❑ Limited D General ❑ Individual O Trustee ❑ Other: Signer is Representing: D Attorney in Fact ❑ Guardian or Conservator �6 r s o= m»00n o ak ])- qZ») k� me< -n ( r-0 CD \\ >m e222 w § 0� w A This page is part ofyour ,- ch,f.,„4.,g 20210074793 76`Pk r�i � RecoRecords Recorder's l"C"n . kl7 A_ ?.t F 01/14/21 AT 10:28AM FEES: 0.00 TAXES: 0.00 OTBER: 0.00 PAID: 0.00 II I II lIl 111111ILl Ill ILl I ILID IL I UI 11111111111111 1l 1l lii LEA SH ET 0019701637 1101 111 I El 11111 20 101142820067 UI DII H 10 II 1011 11110 0II ID 0I II SEQ: 01 HI ID ft HI 0110110 IOU H DIM I I 10II IU Oil I IH H liii H lU - IIlIIHIIIIIIIIRIIIIIIIIIIIIIIIIII11IIIIIIUIIIIIIW RECORDING,REQUESTED BY --__________ -- 19701537 CITY OF ROSEMEAD 1111111111111111111111111111111 AND WHEN RECORDED MAIL TO: Batch Number: 11679494-- 111111111111111111111111111 IIIIIIIIIIILIIIIIIIIII//IIIIIIIIIIIII//III Name City of Rosemead Street Address 8838 E. Valley Blvd. City&State Rosemead, CA 91770 ATTN: CITY CLERK SPACE ABOVE THIS LINE FOR RECORDER'S USE Notice of Completion Notice is hereby given that: 1. The undersigned is owner of the interest or estate stated below in the property hereinafter described. 2. The full name of the undersigned is: City of Rosemead 3. The full address of the undersigned is: 8838 E. Valley Blvd., Rosemead, CA 91770 4. The nature of the title of the undersigned is: In fee (If other than fee,strike"In fee"and insert,for example,"purchaser under contract of purchase",or"lessee") 5. The full names and full addresses of all persons, if any,who hold title with the undersigned are: Names Addresses N/A N/A 6. The names of the predecessors in interest of the undersigned, if the property was transferred subsequent to the commencement of the work of improvement herein referred to: Names Addresses N/A N/A (If no transfer made,insert,"none".) 7. A work of improvement on the property hereinafter described was completed on: December 8, 2020 8. The name of the contractor, if any for such work of improvement was: FS Contractors, Inc. 14838 Bledsoe Street, Sylmar, Ca. 91342 9. The property on which said work of improvement was completed is in the City of Rosemead County of Los Angeles , State of California, and is described as follows: Jay Imperial Park Crosswalk Installation and Sidewalk Replcement Project 10. The street address of said property is: as listed in No. 9 (If no street address has been officially assigned,insert"none") Signature of owner named Dated: 4/6/2 / in paragraph 2: Chris Daste Director of Public Works • By: City of Rosemead ti I certify (or declare) under penalty of perjury that the foregoing is true and correct. /4/2- Date Chris Daste Director of Public Works City of Rosemead, California Rosemead, CA Place of Execution y . . k CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE § 1189 A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California 1 County of ® >� � S � 1J} . On RQl\kUB, kJ dialbefore me, 1V19�J \kW)60) I )M �U�o�`l� , D e Here InsertName and Title of the O cer personally appeared r\S a 'f Namey'of Signer}'' who proved to me on the basis of satisfactory evidence to be the person(rwhose name ismr subscribed to the within instrument and acknowledged to me that heii&lirefttreq executed the same in .hisAker419.eir authorized capacity(jK and that by his/i,..,/ll 1eii signature%on the instrument the personKor the entity upon behalf of which the person acted, executed the instrument. I certify under PENALTY OF PERJURY under the ,..,,,t NATALIE HAWORTH laws of the State of California that the foregoing '" ." Notary Public-California paragraph is true and correct. �_ �: •••� •r- Los Angeles County > <`' ' (` Commission#2272060 °`°°°+ My Comm.Expires Dec 20,2022 WITNESS my hand and official seal. Signature Natthi 1 v Place Notary Seal and/or Stamp Above Signature o'1Notary Public OPTIONAL Completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Do�r�ten� ®� ���` _1,�� Title or Type of Document: uu� Wt Document Date: k/(.D/2J2\ Number of Pages: 3 Signer(s) Other Than Named Above: IIA Capacity(ies) Claimed by Signer(s) ' Signer's Name: Signer's Name: ❑ Corporate Officer— Title(s): 0 Corporate Officer— Title(s): ❑ Partner— 0 Limited 0 General 0 Partner— 0 Limited 0 General ❑ Individual 0 Attorney in Fact 0 Individual 0 Attorney in Fact ❑ Trustee 0 Guardian of Conservator 0 Trustee 0 Guardian of Conservator ❑ Other: 0 Other: Signer is Representing: Signer is Representing: ©2017 National Notary Association - — " FSCON-2 OP ID:J1 ACOIeO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY() `.I 01/2212021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poilcy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER . • 916-364-7380 MTCT Daniel Brock - Sierra Oak Insurance Services PHOFE 916-364-7380 I FAX,No):916-364-7381_ Lic#OC97528. (A1C,No,Ext): (A1C 9700 Business Park Dr.Ste 105 ADDRESS:certsteinsurancespecialist.com Sacramento,CA 95827 Daniel E. Brook INSURER(S)AFFORDING COVERAGE- NAIC 0 INSURER A:California Automobile Ins.Co. 38342 INSURED INSURER B:Scottsdale Insurance Company 41297 Contractors Inc 14 an 83$Bledsoe St INSURERC: p y Admiral Insurance Com 24856 14 Sylmar,CA 91342 INSURER D:Insurance Companyof the West 27847 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED:ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE IVSD D, POLICY NUMBER (RI MMI POLICY (MMIDCOIYYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR BCS0039132 01/13/2021 01/1312022 DAMAGETO RENTED 100,000 X PREMISES(Ea occurrence) $ Exiuded MED EXP(Anv one person) $ PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 , POLICY X JECT LOC PRODUCTS-COMP/OP AGG _3 2,000,000 . OTHER: --• • $ A AUTOMOBILE LIABILITYCOMBINED SINGLE LIMIT 1,000,000 • (Ea accident) - $ X. ANY AUTO BA040000054387 08126/2020 08/26/2021 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOSREONLY _ AUTOS W BODILY INJURY(Per accident) $ AUTOS ONLY _ AUTOS ONI YD {Pere ciid ntpAMAGE $ — $ B UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,000 X EXCESS LIAB CLAIMS-MADE XLS0117705 01/13/2021 01/13/2022 AGGREGATE $ 8,000,000 DED RETENTION$ GL-CAU-WC $ D Atm EMPLCOMPENSATION YERS LIAAB LI ITY X STATUTE ER H ANY PROPRIETORIPARTNERIF�CUTIVE YIN WSA 5032771 05 07/31/2020 07/31/2021 E.L.EACH ACCIDENT $ 1,000,000 O FICERIMEMBER EXCLUDED? N IA ( andatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,00%000 �� DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Pollution FEIECC2584002 01/13/2021 01/13/2022 Occurrenc 5,000,000 Aggregate 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Job:Crosswalk Installation Project#28011 &Sidewalk Replacement Project #24008.Various Locations Rosemead.City of Rosemead to be named additional insured on the general liability. CERTIFICATE HOLDER CANCELLATION CITYROS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Rosemead 8838 E.Valley Blvd. Rosemead,CA 91770 AUTHORIZED REPRESENTATIVE Izirseadivi4464, ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ___......-mmIN FSCON-2 OP ID:J1 A4C—Q/�p®" CERTIFICATE OF LIABILITY INSURANCE DATEIDDIYYYY) 46.....------• 0011211!21!2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER. • 916-364-7380 CONTACT Dan Brock Sierra Oak insurance Services PHONE 916-364-7380 I FAX 916-364-7381 LIC#0C97528 (A/C,No,Ext): (AIC,No): 9700 Business Park Dr.Ste 105 E-MAIL certsceinsurancespecialist.com Sacramento,CA 95827 ADDRESS: Daniel E.Brock INSURER(S)AFFORDING COVERAGE NAIC II INSURERA:Mercury Insurance Company 27553 INSURED FS Contractors,Inc. INSURER B:The'Ohio Casualty Insurance Co 24074 14838 Bledsoe St INSURER C:Scottsdale Insurance Company 41297 Sylmar,CA 91342 INSURER D:Insurance Company of the West 27847 INSURER E:Admiral Insurance Company24856 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR !NSD WVD (MMIDDIYYYY) (MMIDDIYYYY) 1,000,000 C X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE X OCCUR BCS0038453 01/13/2020 01/13/2021 DAMAGETO RENTED 100,000 X PREMISES(Ea occurrence! $ MED EXP(Any one person) $ Exluded • PERSONAL&ADV INJURY $ 1,000'000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X jECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY' (Ea acccidentSINGLE LIMIT $ 1,000,000 X ANY AUTO BA040000054387 08/26/2019 08/26/2020 BODILY INJURY(Per person) $ OWNED ONLY _ AUTNOpSWULEEDp BODILY INJURY(Per accident) $ . AUTO ONLY _ AUTOS ONNLY (Per accidentDAMAGE $ — C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 8,000,000 EXCESS LIAB CLAIMS-MADE XLS0112973 01/13/2020 01/13/2021 AGGREGATE $ 8,000,000 DED RETENTION$ GL/CA/WC $ D WORKERS COMPENSATION X STRTUTE 0R TH AND EMPLOYERS'LIABILITY WSA 5032771 04 • 07/31/2019 07/31/2020 1,000,000 OFFICERJMEMBER EXCLUDED? CUTIVE' YIN NIA E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Pollution 'FEIECC25840-01 01/13/2020 01/13/2021 Occurance 5,000,000 Aggregate 10,000,000 E C TIDN OF OP TI N CAT! SIVE I or 01 Addltl em rks Schedul ,Awed'ed If more space Is required) .iob:f rosswairlAnT taiiation ojec l uii grdewalK epiacement #24008.Various Locations Rosemead.City of Rosemead to be named a ditional insured on the general liability. , CERTIFICATE HOLDER CANCELLATION CITYROS . SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Rosemead ._ 8838 E.Valley Blvd. Rosemead,CA 91770 AUTHORIZED REPRESENTATIVE I ..ZiptidAterida• ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: BCS0038453 COMMERCIAL GENERAL LIABILITY CO 20 37 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies Insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) Location And Description Of Completed Operations ANY PERSON OR ORGANIZATION WHEN ALL.LOCATIONS REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLIES,THAT SUCH PERSON OR ORGANIZATION BE ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Information required to complete this Schedule, if not shown above, will be shown In the Declarations. A. Section II — Who Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown in the Schedule, but only insurance afforded to such additional insured with respect to liability for"bodily injury"or"property will not be broader than that which you are damage"caused,in whole or in part, by"your work" required by the contract or agreement to provide at the location designated and described in the for such additional insured. Schedule of this endorsement performed for that additional insured and included in the "products- completed operations hazard". However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and CG 20 3712 19 ©Insurance Services Office, Inc., 2018 Page 1 of 2 B. With respect to the insurance afforded to these additional insureds, the following is added to Section III—Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement;or 2. Available under the applicable limits of insurance; whichever is less. This endorsement shall not increase the applicable limits of insurance. • • Page 2 of 2 ©Insurance Services Office, Inc., 2018 CG 20 37 12 19 POLICY NUMBER: BCS0038453 COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations ALL LOCATIONS ANY PERSON OR ORGANIZATION WHEN REQUIRED BY WRITTEN CONTRACT OR AGREEMENT, EXECUTED PRIOR TO THE OCCURRENCE TO WHICH THIS INSURANCE APPLIES,THAT SUCH PERSON OR ORGANIZATION,13E ADDED AS AN ADDITIONAL INSURED ON YOUR POLICY Information required to complete this Schedule, if not shown above,will be shown in the Declarations. A. Section II — Who Is An Insured is amended to 2. If coverage provided to the additional insured is include as an additional insured the person(s) or required by a contract or agreement, the organization(s) shown in the Schedule, but only insurance afforded to such additional insured with respect to liability for"bodily injury", "property will not be broader than that which you are damage" or "personal and advertising injury" required by the contract or agreement to provide caused, in whole or in part, by:. for such additional insured. 1. Your acts or omissions;or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: • 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and • CG 20 10 12 19 ©Insurance Services Office, Inc., 2018 Page 1 of 3 B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: 1. All work,including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the • covered operations has been completed; or 2. That portion of "your work" out of which the injury or damage arises has been put to its intended use byany person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. Page 2 of 3 ©Insurance Services Office, Inc., 2018 CG 20 10 1219 a C. With respect to the insurance afforded to these 2. Available under the applicable limits of additional insureds, the following is added to insurance; Section III—Limits Of Insurance: whichever is less. If coverage provided to the additional insured is This endorsement shall not increase the applicable required by a contract or agreement, the most we limits of insurance. will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement;or • CG 20 10 12 19 Q Insurance Services Office, Inc., 2018 Page 3 of 3