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0 <br />SUnLiLLIA:vCE. <br />This Endorsement Changes The Policy. Please React It Carefully. <br />ADDITIONAL INSURED <br />BLANKET - PRIMARY <br />Tnls encorsemenr modifies Insurance provided under the following <br />COMMERCIAL GENERAL LIABILITY COVERAGE FORM <br />SCHEDULE <br />Name of Person or Organization: <br />Ally person or organization to whom or to wnicn you are coligateo Dy Vlrrue of a written contract or oy the <br />issuance or exrence of a permit, to provloe Insurance such as IS afforded Dy IMS policy. <br />(Ir no entry appears aoove, Information required to complete tnls endorsement wilt Do snown in the Declarations <br />as applicamle to ttbs anocrsement ) <br />SECTION II - WHO IS AN INSURED Is amended to Include as an Insured the person or organization snown In <br />the SCHEDULE, put only with respect to Ilaooity arising out of your wont' for that Insures Dy or for you. <br />If you are required by a written contract to provide primary Insurance. INS policy snail oe primary as respects your <br />negligence and SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, 4. Other Insurance does <br />not apply, out only wtn respect to coverage provicea oy Inis policy <br />Tnls endorsement effective 2-13-03 <br />forms part of Policy Numtler K2HA122245 <br />Issued to KEN THOMPSON INC <br />ZY <br />_ Endorsement No <br />RSui 1505 0802 I, -.eludes oopyrlgntec material of Insurance Services Office, Inc 1984 <br />(CG 2010 1185) wrtn RS permission <br />APPROVED AS TO FORM <br />L,aur�I 5hcaly <br />yar,nly tilY ,At Orngy <br />