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POLICY NUMBER: 680-51-1299911 <br />COMMERCIAL GENERAL LIABILITY <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 />Names of Additional Insured Person(s) or Organization(s): <br />Any person or organization that you agree in a written contract to include as an additional insured on <br />this Coverage Part, provided that such written contract was signed by you before,and is in effect when, <br />the "bodily injury" or "property damage" occurs or the "personal injury" or "advertising injury" offense is <br />committed. <br />Location of Covered Operations: <br />Any project to which a written contract with the Additional Insured Person(s) or Organ¢abon(s) in the <br />Schedule applies. <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 in- <br />clude 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", "property <br />damage", "personal injury" or "advertising injury" <br />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) desig- <br />nated above. <br />B. With respect to the insurance afforded to these <br />additional insureds, the following additional exclu- <br />sions apply: <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring, or "personal injury" <br />or "advertising injury" arising out of an offense <br />committed, after: <br />1. All work, including materials, parts or equip- <br />ment furnished in connection with such work, <br />on the project (other than service, mainte- <br />nance or repairs) to be performed by or on <br />behalf of the additional insured(s) at the loca- <br />tion of the covered operations has been com- <br />pleted; or <br />2. That portion of "your work" out of which the <br />injury or damage arises has been put to its in- <br />tended use by any person or organization <br />other than another contractor or subcontrac- <br />tor engaged in performing operations for a <br />principal as a part of the same project. <br />CG D3 61 03 05 <br />Copyright 2005 The St. Paul Travelers Companies, Inc. All rights r�w®a <br />ghts reservmcv°1 " <br />r. <br />CG T8 03 12 2lncludes copyrighted material of Insurance Services Office, Inc. with its pem 'dn': <br />%*L Picsaar <br />DATE OF ISSUE: 10/29/2021 Rsw��.amUaa" <br />