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S1 * 12/30/2021 * PAC 4614028'07 GREAT AMERICAN ASSURANCE COMPANY <br />*D/B* 754023927 178469 <br />CG 89 70 (Ed. 1 1 /14) <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />SIGNATURE GENERAL LIABILITY BROADENING ENDORSEMENT <br />This Endorsement modifies and is subject to the insurance provided under the following form: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />The following extension only applies in the event that no other specific coverage for the indicated loss <br />exposure is provided under this Policy. If other specific coverage applies, the terms, conditions and <br />limits of that Coverage are the exclusive coverage applicable under this Policy, unless otherwise noted in <br />this Endorsement. This is a summary of the various additional coverages and coverage modifications <br />provided by this Endorsement. For complete details on specific coverages, consult the actual policy <br />wording. <br />Coverage Description <br />Limit of Insurance <br />Page <br />Non -Owned Aircraft <br />Included <br />2 <br />Non -Owned Watercraft <br />Included <br />2 <br />Bodily Injury - Mental Injury, Mental Anguish, Humiliation or Shock <br />Included <br />3 <br />Medical Payments <br />$ 20,000 <br />3 <br />Damage to Premises Rented to You <br />$ 1,000,000 <br />3 <br />Supplementary Payments - Bail Bonds <br />$ 3,000 <br />4 <br />Supplementary Payments - Loss of Earnings <br />$ 1,000 per day <br />4 <br />Newly Formed or Acquired Organizations <br />Included <br />4 <br />Unintentional Failure to Disclose Hazards <br />Included <br />5 <br />Knowledge of Occurrence, Claim or Suit <br />Included <br />5 <br />Property Damage Liability - Elevators <br />Included <br />5 <br />Property Damage Liability - Borrowed Equipment <br />Included <br />5 <br />Liberalization Clause <br />Included <br />6 <br />Amendment of Pollution Exclusion (Premises) <br />Included <br />6 <br />Limited Property Damage to Property of Others <br />$ 5,000 6 <br />Included <br />Additional Insured - Manager or Lessor of Premises <br />CG 89 70 (Ed. 11/14) (Page 1 of 12) <br />