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Mike Prlich & Sons, Inc. <br />POLICY NUMBER: A0152818 <br />COMMERCIAL GENERAL LIABILITY <br />CG 2010 0413 <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 Organization(s) <br />Location(s) Of Covered Operations <br />Any person or organization you are <br />required to add as <br />an additional insured under a written <br />contract or agreement <br />in effect prior to any accident, injury, <br />loss or damage. <br />Information required 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", <br />"property damage" or "personal and advertising <br />injury" caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of 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. If coverage provided to the additional insured <br />is required by a contract or agreement, 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 />CG20100413 <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 arises has been put to its <br />intended use by any person or organization <br />other than another contractor or <br />subcontractor engaged in performing <br />operations for a principal as a part of the same <br />project. <br />© Insurance Services Office, Inc., 2012 <br />_ Risk Management Divisian <br />o O REVIEWED & APPROVED BY. <br />F P,. W&4. <br />Risk Management Analyst <br />64000711 21/22 GL/AU/UMB/WC/POLL I Tina Kennedy 1 9/20/2021 1:59:50 PM (PDT) 1Page 2 of 8 <br />This certificate cancels and supersedes ALL previously issued certificates. <br />