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Forming a part of <br />Policy Number: CBP3094292 <br />Coverage Is Provided In GOLDEN EAGLE INSURANCE CORPORATION <br />Named Insured: <br />Agent: <br />DEKRA-LITE INDUSTRIES, <br />SPECTRUM RISK MANAGEMENT & INS <br />INC. THE JEFFREY LOPEZ <br />REFER TO NAMED INSURED SCHEDULE <br />Agent Code: 4295959 Agent Phone: (949)-756-5730 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - COMPLETED OPERATIONS <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) <br />shown in the Schedule, but only with respect to liability for "bodil' injury" or "property damage" caused, in whole or in <br />part, by "your work" at the location designated and described in the schedule of this endorsement performed for that <br />additional insured and included in the "products -completed operations hazard". <br />SCHEDULE <br />Name Of Additional Insured Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION WHEN YOU AND SUCH PERSON OR <br />ORGANIZATION HAVE AGREED IN WRITING IN A CONTRACT, <br />eo <br />AGREEMENT OR PERMIT THATSUCH PERSON ORORGANIZATION <br />ZQ <br />BE ADDED AS AN ADD'L INSURED YOUR POLICY TO PROVIDE <br />�a <br />�,) <br />INSURANCE SUCH AS IS AFFORDED UNDER THIS COVERAGE PART'S <br />Location And Description Of Completed Operations: <br />`X50 <br />LISP �C{y pttoCney <br />ANY LOCATION AT WHICH YOU PERFORMED WORK DESCRIBED IN <br />PSS`Star <br />WRITING IN THE CONTRACT, AGREEMENT OR PERMIT FOR A <br />PERSON OR ORGANIZATION THAT HAS BEEN QUALIFIED AS AN <br />ADDITIONAL INSURED IN THIS ENDORSEMENT. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />© ISO Properties, Inc., 2004 <br />CG 20 37 (07104) <br />AGENT COPY <br />04/08/2010 3094292 NEUSXRCB0804 PGDM060D J12484 GCAOPPN 00000470 Page 109 <br />