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POLICY NUMBER: 711-01-63-58-0006 COMMERCIAL GENERAL LIABILITY <br /> CG20101219 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> ORGANIZATION <br /> This endorsement modifies insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name Of Additional Insured Person(s)Or Organization(s) <br /> BLANKET PER SCHEDULE ON FILE WITH NAMED <br /> INSURED <br /> Location(s)Of Covered Operations <br /> Location Building <br /> 1 1 <br /> Information re uired to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> A. Section 111 — Who Is An Insured is amended to in the performance of your ongoing operations for <br /> include as an additional insured the person(s) or the additional insured(s) at the location(s) <br /> organization(s) shown in the Schedule, but only designated above. <br /> with respect to liability for "bodily injury", "property <br /> However: <br /> damage" or "personal and advertising injury" <br /> caused, in whole or in part, by: 1. The insurance afforded to such additional <br /> insured only applies to the extent permitted by <br /> 1. Your acts or omissions; or law; and <br /> 2. The acts or omissions of those acting on your <br /> behalf; <br /> CG 20 10 1219 © Insurance Services Office, Inc., 2018 Page 1 of 2 <br /> E-INSURED <br />