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<br />From: Robin Rabune At RSllOSlJrance t:lrol<ers, Inc. (';I'Jl\lJ(~..::.::q.4 l"'axlU: (1"4-~o-"+"tOI IY. V'fIllIlC r'I. II'V","" ""'.......... <br /> <br />""'<&'''--'' ,.................. ~ ,.~..... ,.. , -0;0-- - -,- <br /> <br />POLICY NUMBER: <br /> <br />COMMERCIAL GENERAL LIABILITY <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - (FORM B) <br /> <br />ThiS endorsement modifies insurance provided under the foHowing: <br /> <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br /> <br />Any person or orga1ization to which you are obligated by virtue of written contract to provide insurance <br />such as is afforded by this policy, but only with respect to (1) occurrences taking place after such written <br />contract has been executed and (2) OCCurrences resulting from work performed by you during the policy <br />period. 01'" occurrences resutting from the conduct of yotJf business during the poliCY period_ <br /> <br />(If no entry appears above, information recuired to complete this endorsement will be shown in the Declarations as <br />applicable to this endorsement.) <br /> <br />WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the <br />Schedule. bot only w~h respect to lIabilily arising out of "your work" for that ins~ by or for you. <br /> <br />Coverage provided by this poi icy to the Additionallnsured(s) shown in the Schedule shall be <br />primary insurance and any other insurance maintained by the Addi!ionallnsured(s) shall be <br />excess and non-contributory. but only as respects any claim or fiability determined to be the <br />result of the sole negligence Of responsibility of the Named Insured and only if required of the <br />Named Insured by WIillen contract. <br /> <br />CG 2010 1185 <br /> <br />Copyright. insurance Services Office, Inc., 1984 <br /> <br />Page 1 of 1 <br /> <br />o <br /> <br />_._..._.-;f}L~0.~/,:: <br /> <br />"..," _.:' <br />