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DMS Facility Services, LLC <br />Policy Term 10/l/2021-10/l/2022 <br />Commercial General Liability <br />Policy Number TB2-691-458727-081 <br />Issued by Liberty Mutual Fare 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 po'icy providing coverage for <br />the same "occurrence', claim or "suit". <br />Schedule <br />Person or Organization: <br />All persons or organirations 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 O 2013 Liberty Mutual Insurance, All rights reserved. Page 1 of I <br />Includes copyrighted material of Insurance Services Office. Inc., with is permission. <br />. <br />Rifil Mudgancnf Dhisbri <br />WviEwm & APPROVED BY' <br />99W <br />Risk KF ge tOei-1Aide <br />