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04 K° <br />SIIr lilt [ ta�lri Ce <br />Commercial General Liability i ssa IxII�Iicrn <br />LIBERTY SURPLUS INSURANCE CORPORA'T'ION <br />(A New Ilampshire Scoria insurance (-'ompany, hn'cinaftco the Toinpanh') <br />ENDORSEMENT NO. <br />Effective Date: 05/01/18-05/01/19 <br />Policy Numbev 1000200843-03 <br />Issued To: All City Management Services, Inc. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — <br />SCIIEDULED PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL, GENERAL LIABILITY COVERAGE PART <br />SCHTWULE <br />Name Of Additional Insured Person(s) <br />Or Organizations) Location(s) Of Covered Operations <br />Any person or organization for whom you are <br />performing operations when you and such person or <br />organization have agreed in writing in a contract or <br />agreement that such person or otganization be added <br />as an additional insured on your policy; <br />Any other person or organization you are required to <br />add as an additional insured under the contract or <br />agreement described in the paragraph above. <br />All locations of covered operations. <br />(Information required to complete this Schedule, if not shown above, will be shown in the Declarations) <br />A. Section II — Who Is An Insuted is amended to include as an additional insured the person(s) or organization(s) <br />shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and <br />advertising injury" caused, in whole or in part, by: <br />1. You]: acts or omissions; or <br />2. The acts or omissions of those acting on your behalf; <br />in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.. <br />R. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: <br />This insurance does not apply to "bodily injury" or "property damage" occurring after: <br />1. All work, including anaterials, parts or equipment furnished in connection with such work, on the project (other <br />than service, maintenance or repairs) to be performed by or on behalf of the additional insurcd(s) at the <br />location oEthe coveted operations has been completed; or <br />2 <br />CG 20 10 0704 <br />© ISO Properties, Inc., 2004 <br />