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Attachment Code: D531339 Certificate TD: 15596103 <br />POLICY NUMBER: 64309404 <br />COMMERCIAL GENERAL LIABILITY <br />CG 2010 04 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY., <br />ADDITIONAL INSURED OWNERS, LESSEES OR <br />CONTRACTORS SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) <br />-Or Or anization s .......... Location s. Of Covered Operations, <br />WHERE REQUIRED BY WRITTEN CONTRACT: ALL LOCATIONS WHERE REQUIRED BY WRITTEN CONTRACT: <br />I <br />Information, retired to complete this Schedule If not shown above, will.be shown in the Declarations, <br />A. Section II -Who Is An Insured is amended to <br />include as an additional insured the person(s) or <br />organization(s) shown in the Schedule, but only <br />with respect to liability for "bodily injury", "property <br />damage" or "personal and advertising Injury" <br />caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions at those acting on your <br />behalf; <br />in the performance of your ongoing operations for <br />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 by <br />law; and <br />2. It coverscqla roYiiippd to the Adltjonal insured is <br />requlred:p r a Cbntr2ct ar agramrant, the <br />insurance afforded to such additional insured <br />will not be broader than that which you are <br />required by the contract or agreement to <br />provide for such additional insured. <br />B. 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" or <br />"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 or <br />on behalf of the additional insured(s) at the <br />location of the covered operations has been <br />completed; or <br />2. That portion of "your work" out of which the <br />injury or damage asses has been put to its <br />intended use by any person or organization <br />other than another contractor or subcontractor <br />engaged in performing operations for a <br />principal as a part of the same project. <br />CG 20 10 04 13 © Insurance Services Office, Inc., 2012 page 1 f0 <br />