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Feb -10 -2006 05:03PM From -March CSU <br />POLICY NUMBER: GL 643 -93 -13 <br />+9546363770 T -003 P 004/006 F -104 <br />COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - (FORM B) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART. <br />SCHEDULE <br />Name of Person or Organization: <br />BLANKET AS REQUIRED BY WRITTEN CONTRACT <br />(If no entry appears above, information required to complete this endorsement will be shown In the Declarations as <br />applicable to this endorsement.) <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. <br />APPROVED AS 's FC�i2T ✓1 <br />La ra Stitt S",._edy <br />Assistant City Attorr _p <br />CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 Page 1 of 1 11 <br />