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DMS Facility Services <br />Policy term 10-1-19 to 10-1-20 <br />GL Policy #TB2-691-458727-089 <br />Policy Number <br />Issued by Liberty Mutual Fire Insurance Co. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />OTHER INSURANCE AMENDMENT —SCHEDULED ADDITIONAL INSURED <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART <br />LIQUOR LIABILITY COVERAGE PART <br />If you are obligated under a written agreement to provide liability insurance on a primary, excess, contingent, or any <br />other basis for any person or organization shown in the Schedule of this endorsement that qualifies as an additional <br />insured on this policy, this policy will apply solely on the basis required by such written agreement and Paragraph 4. <br />Other Insurance of Section IV - Conditions will not apply. If the applicable written agreement does not specify on <br />what basis the liability insurance will apply, the provisions of Paragraph 4.Other Insurance of Section IV - Conditions <br />will govern. However, this insurance is excess over any other insurance available to the additional insured for which <br />it is also covered as an additional insured by attachment of an endorsement to another policy providing coverage for <br />the same "occurrence", claim or "suit". <br />Schedule <br />Person or Organization: <br />All persons or organizations with whom you have entered into a written contract or agreement, prior to an occurrence <br />or offense, to provide additional insured status. <br />LC 24 20 02 13 0 2013 Liberty Mutual Insurance, All rights reserved. Page 1 of '1 <br />Includes copyrighted material of Insurance Services Office. Inc., with its permission. <br />RgEVRIEWM D & ANAqEMPPRENTpOV oD <br />7 2019 <br />FRA CAVE R. VILLAREAL <br />