Laserfiche WebLink
SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Organization(s) Location(s) Of Covered Operations <br /> All persons or organizations with whom you have entered All locations as required by a written contract or <br /> into a written contract or agreement, prior to an agreement entered into prior to an "occurrence"or <br /> "occurrence"or offense,to provide additional insured status. offense. <br /> Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> \ / <br /> e„o�,k9P Rlak ManagenmentDivision <br /> 6ry REVIEWED&APPROVED BY: <br /> u �rf A Acevedo <br /> �' Risk Management Specialist <br /> / 1 <br /> CG 20 10 04 13 © Insurance Services Office, Inc., 2012 Page 2 of 2 <br />