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NQ1115125112477 <br />POLICY NUMBER: <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 12 04 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED – STATE OR GOVERNMENTAL <br />AGENCY OR SUBDIVISION OR POLITICAL <br />SUBDIVISION – PERMITS OR AUTHORIZATIONS <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />State Or Governmental Agency Or Subdivision Or Political Subdivision: <br />DJUZ!PG!TBOUB!BOB <br />Sjtl!Nbobhfnfou!Ejwjtjpo <br />31!Djwjd!Dfoufs!Qmb{b <br />Tboub!Bob-!DB-!:3813 <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />2.This insurance does not apply to: <br />A.SectionII–WhoIsAnInsured isamendedto <br />includeasanadditionalinsuredanystateor <br />a."Bodilyinjury","propertydamage"or <br />governmentalagencyorsubdivisionorpolitical <br />"personalandadvertisinginjury"arisingout <br />subdivisionshownintheSchedule,subjecttothe <br />ofoperationsperformedforthefederal <br />following provisions: <br />government, state or municipality; or <br />1.Thisinsuranceappliesonlywithrespectto <br />b."Bodilyinjury"or"propertydamage" <br />operationsperformedbyyouoronyourbehalf <br />includedwithinthe"products-completed <br />forwhichthestateorgovernmentalagencyor <br />operations hazard". <br />subdivisionorpoliticalsubdivisionhasissueda <br />B.Withrespecttotheinsuranceaffordedtothese <br />permit or authorization. <br />additionalinsureds,thefollowingisaddedto <br />However: <br />Section III – Limits Of Insurance: <br />a.Theinsuranceaffordedtosuchadditional <br />Ifcoverageprovidedtotheadditionalinsuredis <br />insuredonlyappliestotheextentpermitted <br />requiredbyacontractoragreement,themostwe <br />by law; and <br />willpayonbehalfoftheadditionalinsuredisthe <br />b.Ifcoverageprovidedtotheadditionalamount of insurance: <br />insuredisrequiredbyacontractor <br />1.Required by the contract or agreement; or <br />agreement,theinsuranceaffordedtosuch <br />2.AvailableundertheapplicableLimitsof <br />additionalinsuredwillnotbebroaderthan <br />Insurance shown in the Declarations; <br />thatwhichyouarerequiredbythecontract <br />oragreementtoprovideforsuchadditional <br />whichever is less. <br />insured. <br />Thisendorsementshallnotincreasetheapplicable <br />Limits of Insurance shown in the Declarations. <br />© Insurance Services Office, Inc., 2012 <br />CG 20 12 04 13 <br />Page 1 of 1 <br />JOTVSFE <br /> <br />