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Big Ben, Inc. <br />POLICY NUMBER: 1000066896251 COMMERCIAL GENERAL LIABILITY <br />Effective 04/05/2025 - 04/05/2026 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 />AS REQUIRED BY WRITTEN CONTRACT SIGNED BY BOTH PARTIES <br />PRIOR TO LOSS <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 any state or <br />governmental agency or subdivision or political <br />subdivision shown in the Schedule, subject to the <br />following provisions: <br />1. This insurance applies only with respect to <br />operations performed by you or on your behalf <br />for which the state or governmental agency or <br />subdivision or political subdivision has issued a <br />permit or authorization. <br />However: <br />2. This insurance does not apply to: <br />a. 'Bodily injury", "property damage" or <br />"personal and advertising injury" arising <br />out of operations performed for the federal <br />government, state or municipality; or <br />b. 'Bodily injury" or "property damage" <br />included within the "products -completed <br />operations hazard". <br />B. With respect to the insurance afforded to these <br />additional insureds, the following is added to <br />Section III — Limits Of Insurance: <br />a. The insurance afforded to such additional If coverage provided to the additional insured is <br />insured only applies to the extent permitted required by a contract or agreement, the most we <br />by law; and will pay on behalf of the additional insured is the <br />b. If coverage provided to the additional amount of insurance: <br />insured is required by a contract or 1. Required by the contract or agreement; or <br />agreement, the insurance afforded to such <br />additional insured will not be broader than 2• Available under the applicable Limits of <br />that which you are required by the contract Insurance shown in the Declarations; <br />or agreement to provide for such additional whichever is less. <br />insured. This endorsement shall not increase the applicable <br />Limits of Insurance shown in the Declarations. <br />CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 <br />