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<br />May. J. 200 j 1: 2 J QM <br />, <br /> <br />B r 0 IV r & B r 0 wr [n c <br /> <br />'~ 0 24 [ [ <br /> <br />p. 3 <br /> <br />POUCY NUMBER: GLPOO00568996400 <br /> <br />COMMERCIAL GENERAL LIABILITY <br />CG 20 1101 911 <br /> <br />THIS ENDORSEMENT CHANGES THE POUCY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - MANAGERS OR LESSORS OF PREMISES <br /> <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL liABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />1. Designation of Premises (Part Leased to You): <br /> <br />2.. Name of Person or Organization (Additional Insured): <br />AS REPORTED AND APPROVED <br /> <br />APPROVED AS TO FORM <br /> <br />YB5 2/ C; <br /> <br />/ Laura Stitt Sheedy <br />Assistant City A HorneY <br /> <br />3. Additional Premium: INCL1lIlED <br /> <br />(If no entry appears above, the informa~on required to complete this endorsemant will be shown in the Declarations as <br />applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is emended to Include as an insured the person or organization shown in the Schedule <br />but only with respect to liability arising out of the ownership, maintenance or uSe 01 that part of the premises leased to you <br />and shown In the Schedule and subject to the following addillonal exclusions' <br /> <br />This insurance does not apply to: <br /> <br />t. Any "occurrence' which takes place after you cease to be a tenant in that premises. <br /> <br />2. structural alterations, new construction or demolition operations performed by or on b<lhalf of the person or organization <br />shown in the Schedule <br /> <br />CG20 11 0196 <br /> <br />Copyrigh~ 'nsur.""" Servlcee OItlce. Inc.. 1994 <br /> <br />Page 1 ot 1 <br /> <br />