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COMMERCIAL GENERAL LIABILITY <br />III <br />POLICY NUMBER: <br />2CN0165-7335 <br />MARKEL® EVANSTON INSURANCE COMPANY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />BLANKET ADDITIONAL INSURED <br />This endorsement modifies insurance provided under the following <br />COMMERCIAL GENERAL LIABILITY COVERAGE FORM <br />PRODUCTS/COMPLETED OPERATIONS COVERAGE FORM <br />LIQUOR LIABILITY COVERAGE FORM <br />PROFESSIONAL LIABILITY COVERAGE FORM <br />Please refer to each coverage form to determine which terms are defined. Words shown in quotations on this endorse- <br />ment may or may not be defined in all coverage forms. <br />SCHEDULE <br />Person or Entity: Any person or organization to whom you are obligated by valid written contract to provide such <br />coverage, <br />Additional Premium: $ (Check box if fully earned.®) <br />Included <br />WHO IS AN INSURED is amended to include the person or entity shown in the Schedule above as an Additional Insured <br />under this insurance, but only as respects negligent acts or omissions of the Named Insured and only as respects any <br />coverage not otherwise excluded in the policy. Our agreement to accept an Additional Insured provision in a contract is <br />not an acceptance of any other provisions of the contract or the contract in total. <br />When coverage does not apply for the Named Insured, no coverage or defense shall be afforded to the Additional In- <br />sured. <br />No coverage shall be afforded to the Additional Insured for injury or damage of any type to any "employee" of the Named <br />Insured or to any obligation of the Additional Insured to indemnify another because of damages arising out of such injury <br />or damage. <br />All other terms and conditions remain unchanged, <br />MEGL 0009.01 04 11 Includes copyrighted material of Insurance Services Office, Inc. Page 1 of 1 <br />with its permission. <br />