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SCOTTSIIAIX INSURANCE COMPA_� <br />ENDORSEMENT <br />NO. <br />ATTAc H ED TO ANO <br />EN:6D RSEM ENT EFFEC THE DATE <br />Fa RIVING APAFn'DF <br />I12.O�A.N. STANDARDTIN.E) <br />HAM ED INSURED <br />AGENT NO. <br />POLICY NVMHER <br />;L Sr^ -EL' HSi.^, Y,3GY= 7Ill <br />04{}Sr <br />THIS ENDORSEMENT CHANGES THE POLICY_ PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -OWNERS, LESSEES OR <br />CONTRACTORS SPECIAL CONDITION <br />If any of the endorsements below are attached to this policy, coverage provided by the additional insured <br />endorsement is amended to be afforded on a primary, noncontributory or primary and noncontributory <br />basis when and as agreed to in writing in a contract or agreement between you and the additional insured. <br />Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organization (CG 20 10) <br />Additional insured - State Or Political Subdivisions - Permits (CG 20 12) <br />Additional Insured - Owners., Lessees Or Contractors - Automatic Status When Required In Construc- <br />tion Agreement With You (CG 20 33) <br />Additional Insured - Owners, Lessees Or Contractors - Completed Operations (CG 20 37) <br />Other- (Specify title and form number) <br />' ?12 -slit <br />AUTHORIZED REPRESENTATIVE DATE <br />GLS -295s (7-08) P.O. 1 or 1 <br />AGENT 93-2453_ r.ap <br />