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POLICY NUMBER: CPP 0105807 04 COMMERCIAL GENERAL LIABILITY CG 03 00 01 96 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DEDUCTIBLE LIABILITY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART SCHEDULE Coverage Amount and Basis of Deductible PER CLAIM or PER OCCURRENCE Bodily Injury Liability $ $ Property Damage Liability $ $ Bodily Injury Liability and/or Property Damage Liability Combined $ $ 5, 000 (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) APPLICATION OF ENDORSEMENT (Enter below any limitations on the application of this endorsement. If no limit- ation is entered, the deductibles apply to damages for all "bodily injury" and "property damage", however caused): *SEE FORM CG1690491 A. Our obligation under the Bodily Injury Liability and Property Damage Liability Coverages to pay damages on your behalf applies only to the amount of damages in excess of any deductible amounts stated in the Schedule above as applicable to such coverages. B. You may select a deductible amount on either a per claim or a per "occurrence" basis. Your selected de- ductible applies to the coverage option and to the basis of the deductible indicated by the placement of the deductible amount in the Schedule above. The deductible amount stated in the Schedule above ap- plies as follows: 1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule above is on a per claim basis, that deductible applies as follows: a. Under Bodily Injury Liability Coverage, to all damages sustained by any one person be- cause of "bodily injury"; b. Under Property Damage Liability Coverage, to all damages sustained by any one person because of "property damage"; or c. Under Bodily Injury Liability and/or Property Damage Liability Coverage Combined, to all damages sustained by any one person be- cause of: (1) "Bodily injury"; (2) "Property damage"; or (3) "Bodily injury" and "property damage" combined as the result of any one 'occurrence". If damages are claimed for care, loss of services or death resulting at any time from "bodily injury", a separate deductible amount will be applied to each person making a claim for such damages. With respect to "property damage", person in- cludes an organization. 2. PER OCCURRENCE BASIS. If the deductible amount indicated in the Schedule above is on a "per occurrence" basis, that deductible amount applies as follows: 1 CG 03 00 01 96 Copyright, Insurance Services Offices, Inc., 1994 �oRaN } z RiskMmWmedDMsfan REVIEWED & APPROVED SY.- f R. V;&wd Risk Management Analyst