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POLICY NUMBER:
<br />CG 20 101112 11
<br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
<br />ADDITIONAL INSURED —OWNERS, LESSEES OR
<br />CONTRACTORS
<br />.(WITH LIMITED COMPLETED OPERATIONS COVERAGE)
<br />This endorsement,modifles Insurance provided under the followings
<br />COMMERCIAL GENERAL LIABILITY COVERAGE PART'
<br />BVSINESSOWNERS COVERAF,FOIRM�,
<br />SCHEDULE
<br />4E OF PERSON -bRORGANIZATIO
<br />j1hp quAlHylog language 4bovp because of
<br />Any person brarganization'to whqM or towhlGh
<br />paymenN we snake foflnjury:
<br />the nalmed insured is obligated by A virtue of A
<br />written contract, to provide, in%jqrAjjpe that, is
<br />LOCATION 6F JQB
<br />,
<br />afforded. by this. pofloy. Where required by
<br />The job iqqgtion Must be within the State, Of
<br />contract, the Officers, officials envOy0s,
<br />Any d withinornici of the riannedinsured, or w ,
<br />directors, sulpl$rdiarjesi partners; SUCCOSSO'Ka.
<br />bonfiguous State -therefor
<br />pafqrrm, divldom4 archltepts, su-rVeyofs, and
<br />- I
<br />Arioineers are imoludecf, a s addigo na! ins ureds.
<br />tYESQRIF;vT.IQN, OF VvbRk
<br />ig but 60
<br />All other entities iricludir f limited to,
<br />The rtyp a of work Performed rnv,5t be that As
<br />agents, volunteers,,servants, Members, And
<br />desoritTed under clas�sifiq0ti6tis in the CGL
<br />partnerships are inducted as additional insurods,
<br />Goverdge Part Declarations.
<br />7 required by, ooritrao, only when acting within
<br />the course and scope of their'dotlea, controlled
<br />and supervised bythe Primary (first) Additional
<br />Insured. If An Owner Controlled fnsurarioe
<br />Program is Myolved, the aovonage applies to Off-
<br />PRIMARY CLAUSE;
<br />site operations only. If the purpose of this
<br />Whqn this, endorsement applies and when
<br />endoosemerjt is for bid purp0qgs only, therl:r)Q
<br />teci uIr., I Ad by, written contract, suph insurance as;
<br />coverage applies;
<br />is afford'ed , by the QooQrqt jiablljty policy Is,
<br />primary insuranoe and OthOrins3prarjoe shall, be
<br />HO IS AN INSURED{Section II")
<br />excess and shelf fiat contribute to the insurance�
<br />This s gtion is pMerpftcl to jo an
<br />4$
<br />afforted by this endorsement_.
<br />Insuredthe pqrs-on of orqarilzallonw[Ittiln,tile-
<br />scopeoftho,qualifying language ,above, but tiny
<br />EXCL(Atd I
<br />to the extent that the person of OTgalf7-ptian is
<br />This insurance provided to the additional insured.
<br />hold llabt,Q, for your an� or omissions In the
<br />i ,
<br />"bodily
<br />does not Apply, iQ QOIIY inivry" mpody,
<br />c%rrsa, of "your -WOTO for that person or
<br />damage` qr 1porsoij-pi wd, acNerdsing Inj1jr/_
<br />Organization by or fot you. The "pro4u9ts-
<br />prisng, out of 00 prohitAct'
<br />J S, f0glnOpOs or
<br />...
<br />c Ohl' hazard" portion of. the
<br />PlAtold 0106fatkong d"
<br />surveyor's rendering or failure to render any
<br />IIQY coverage as respects ih�., ireldW041
<br />sp
<br />to -d.ing ,
<br />professional sefvii�qs,iolufr
<br />rwaq,tlqes not Apply to Any work involving of
<br />I 711P Prel)Pffng, 9-PPrOviV, or fAkiT4 to
<br />related to propprfas intended fqr rasiI _ dontlal or
<br />prepare or approve, reaps, d6siqn8,
<br />h4itatioal Occupar(py0fier $6ri Apartments),
<br />shop drawings, ovinioiu_�, reports,
<br />- his clause.: ause, does not affeot he -"prOd14_ls_
<br />t -
<br />sWveYs, field orders,, change Orders, or
<br />,
<br />bb rriojetejoperations" :Ca rage provided _0 to Itip,
<br />drawings and old
<br />nam los
<br />od wp.doj,
<br />2 Qotfmrl�,, qMh(ta0tpTaI or
<br />_qporyisory, insp
<br />engineering gq,(Ivfties'�
<br />WAIVER bF $LjBk`,Q
<br />WOvkivo syright fecp�M When rear Endarsemertt EFF50TIVED4JE:_ SEE DEC
<br />by .,
<br />written oonttact- that may wq, -rlAt have against;
<br />fire w1firin the scope of Endorsement EXPIRATION pAit- -,SEE DEC
<br />Co 20 AP 111 Page 1 OT
<br />h6ludes 0pytighted mzteri6l of I n8tiranc6 S&Niteaoffde, Inc , with rtfii p8!rmMi6h
<br />
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