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POLICY NUMBER: C6983279541 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY . PLEASE READ IT CAREFULLY . <br />ADDITIONAL INSURED -OWNERS , LESSEES OR <br />CONTRACTORS -(FORM B) <br />This endorsement modifies insurance provided under the following : <br />COMMERCIAL GENERAL LIAB ILITY COVERAGE PART . <br />SCHEDULE <br />Name of Person or Organ ization: <br />City of Pleasanton , Pleasanton Unified School District and Hacienda MD (5050 Hopyard Road) are listed as <br />certificate holder. <br />(If no entry appears above , information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organiza tion shown in the <br />Schedule, but only with respect to liability arising ou t of "your work" for that insured by or for you . <br />CG 20 10 11 85 Copyright , Insurance Services Office , Inc., 1984 Page 1 of 1 0 <br />DocuSign Envelope ID: DA631F0B-3C25-4585-9688-3F2684907C15