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POLICY NUMBER: 5268169 <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 10 04 13 <br />This endorsement modifies insurance provided under the following; <br />• <br />SCHEDULE <br />Name Of Additional Insured Person(s) 1—'— ---___ <br />Or Organization(s) _ Location(s) Of Covered Operations <br />ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACTOR AGREEMENT. <br />BECOME OBLIGATED TO INCLUDE AS AN <br />ADDITIONAL INSURED AS A RESULT OF ANY <br />CONTRACT OR AGREEMENT YOU <br />HAVE ENTERED INTO. <br />_ I _ <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A, Section (I - Who Is An Insured is amended to <br />include as an additional insured the person(sl or <br />organization(s) shown in the Schedule, but only <br />with respect to liability for "bodily injury" B. <br />"property damage" or "personal and advertising <br />injury" caused, in whole or in part, by: <br />1, Your acts or omissions; or <br />2. The acts 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 location(s) <br />designated above. <br />However: <br />1. 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 <br />insured is required by a contract or <br />agreement, the insurance afforded to such <br />additional insured will not be broader than <br />that which you are required by the contract <br />or agreement to provide for such additional <br />insured. <br />With respect to the insurance afforded to these <br />additional insureds, the following additional <br />exclusions apply: <br />This insurance does not apply to "bodily injury" <br />or "property damage" occurring after: <br />1. All work, including materials, parts or <br />equipment furnished in connection with such <br />work, on the project (other than service, <br />maintenance or repairs) to be performed by <br />or on behalf of the additionalinsured(si at <br />the location of the covered operations has <br />been completed, or <br />2. That portion of "your work" out of which <br />the injury or damage arises has been put to <br />its intended use by any person or <br />organization other than another contractor or <br />subcontractor engaged in performing <br />operations for a principal as a part of the <br />some project. <br />CG 20 10 04 13 0 Insurance Services Office, Inc., 201 2 Page 1 of 2 11 <br />