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<br />.£: <br /> <br />CHUBB <br /> <br />Liability Insurance <br /> <br />8 <br /> <br />Endorsement <br /> <br />Policy Period <br /> <br />Effective Oa Ie <br /> <br />Policy Number <br /> <br />Insured <br /> <br />Name of Company <br /> <br />Date Issued <br /> <br />JIINE I, 2()()4 TO JUNE I, 2()(),'i <br /> <br />JUNE I, 21)()4 <br /> <br />35XI-57-34 CIII <br /> <br />IJNDEI{WRITERS LABORATORIES INt:. <br /> <br />1:1 ])ERAI, INSlJ RANCI: COM!' ANY <br /> <br />JUNE 11,2004 <br /> <br />:::~::::7::::::::::::::::::=:::::::::::::::::::::;:::;;:::;:::;:::;:::::::::;:;:;:;:;:::;:;:::::::;:::::::::;::::::::::::::::::::::::~:::::::~:;::~:::::::::~:~::::::;::::::::::::::::::::::::::::::::::::::::::~:::::::::;:::;:::::::::::;:::;:;:;:::::::::::::::::::::;:::::::;:;:::::::::::::;:::;:::::::::::;:::::::::::::;:::::::::::::::::::::::::::::::::;:::::;:::;:::::::;:::;:::::::;:;:::;:;:::;:::::;:;:::::::::::;:::::::::::::;:::::::::::::;:::::;:::::;:::::::::::::::::::::::::::::::;::::::::;:::::::::::::::::;::;~::~:x::::::;:::;;:: <br /> <br />This Endorsement applies to ¡he following forms: <br /> <br />GENERAL LI^BILlTY <br /> <br />8 <br /> <br />:::::::::::::::::::::::;:::;:;:::::::;:;:;:::;:;:::::::;:::::;::::::::::::::::::::;:;:::;:::::;:::::~:::::::::::;:::;:::::;:::::::::;:::::::;:::::;;::::;:::;:::;:::::::::;:;:;::::::::::;:::;;:;:;:::;:;:::::;:::;::;;;:;;;::;:::::::::::;:::::::::;:::::;:;:;:;::::;::;::;::;:::::::::::::::;:::::::::::::::::::::;::::::::::::::=::::::::::::::::::::::::;:::::::::;:::;:;:g;:;:;:::;:;::::::::::::::::;:;::::~::::::::;:;::3::::::::::::::::::::::::;::::;:::::::::::;;::::;:;;:::::::;:~::~;:;:::~;::::~::;:::::~~:;:;;::::::;:::::;:;~:;::~:::; <br /> <br />Who Is An Insured <br /> <br />Designated Person Or <br />Organization <br /> <br />8 <br /> <br />Liability Insurance <br />Form 80-02-2367 (Rev 4-01) <br /> <br />Under Who Is An Insured, the following provision is added: <br /> <br />^ny person or organization designated helow is an insurt!d; hut they arc insureds only wilh <br />respect \0 liahility arising out of your operations or premises owned hy or n:ntel! 10 you. <br /> <br />'/:;' <br />j , <br />, )iLU <br />/ <br /> <br />"j / '( <br /> <br />Additiona/lnsured ~ Designated Person Or Organization <br />Endorsement <br /> <br />continued <br />Page 1 <br />