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<br />. <br />rUJllllllY a pan or <br /> <br />Policy Number: CBP8016173 <br />Coverage is Provided In PEERLESS INSURANCE COMPANY - A STOCK COMPANY <br /> <br />i <br />! <br /> <br />Named Insured: <br />DEKRA-L1TE INDUSTRiES INC <br /> <br />Agent: <br />GOLDEN PACIFIC INSURANCE SERVI <br /> <br />Agent Code: 4295138 <br /> <br />Agent Phone: (626i-27&.300D <br /> <br />I <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - COMPLETED OPERATIONS <br /> <br />This endorsement modifies Insurance provided under the following: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />Section II - Who Is An Insured is amended to include as an insured the person or organization shown in the <br />Schedule, but only w.h respect to liahillty arising out of "your work" at the location designated and descrioed in the <br />sctledule of this endorsement performed for that insured and included in the "products-completed operations hazard", <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />ANY PERSON OR ORGANIZATION FOR WHOM A CERTIFICATE OF <br />INSURANCE IS ON FILE WITH THE COMPANY. <br /> <br />Location And Description of Completed Operations: <br /> <br />ANY JOB PERFORMED WITHIN THE POLICY TERM FOR THE ABOVE <br />NAMED. <br /> <br />INCLUDED <br /> <br />APPROVED AS TO FORM <br /> <br />~ 2/'L <br />" Laura Stitt Sheedy <br />Assistant City Attorney <br /> <br />Additional Premium: <br /> <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 /> <br />CG 20 37 (10101) <br /> <br />@ISO Properties. Inc.. 2000 <br />INSURED COpy <br />