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OLD REPUBLIC GENERAL INSURANCE CORPORATION <br />ADDITIONAL INSURED - PRIMARY AND NON-CONTRIBUTORY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: <br />BUSINESS AUTO COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured <br />Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is <br />indicated below. <br />SCHEDULE <br />Name of Person(s) or Organ ization(s): WHERE REQUIRED BY AN EXECUTED WRITTEN <br />CONTRACT. <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the <br />extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision <br />contained in Section II of the Coverage Form. <br />If the person or organization shown in the schedule qualifies as an `insured' for Liability Coverage, and they <br />have coverage as a first named insured under another policy, this policy is primary to and non-contributory <br />with that other insurance. <br />All other terms, conditions, and exclusions apply. <br />Named Insured <br />GRIFFITH COMPANY <br />Policy Number <br />Al CA 9928 18 05 <br />Endorsement No. <br />001 <br />Policy Period <br />12/31/2021 to 12/31/2022 <br />Endorsement Effective Date: <br />12/31/2021 <br />Producer's Name: <br />Alliant Insurance Services, Inc. <br />Producer Number: <br />02P20 <br />AUTHORIZED REPRESENTATIVE <br />CA EN GN 0044 02 12 Page 1 of 1 <br />o NSF Risk Division <br />z <br />REVIEWED & APPROVED BY.- <br />-��" Risk Management Analyst <br />