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Pohey Number., AS2-681-004145-724 <br />I esood by: Liberty Mutual Fire Insurance Company <br />THIS ENDORSEMENT CHANGEs THE POLICY, PLEASE READ IT CAREFULLY. <br />DESIGNATED INVRED - NONGONTRIBUTING <br />This endorsertrant mocifies insurance provided under the following., <br />St)SINEGS ALTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIERS COVERGE FORM <br />TRMCKERS COVERAGE FORM <br />With respect to coverage provided by thla endorsement, (he provisions of the Oavensgre Form apply unless <br />modified by Nis endorsement, <br />This andarsernent identities tuateon(s) or organizatton(s) who are 'Insureds" under the Who Is An Insured <br />Provision of the Covaralie Form. This andarsement does not alter coverage provided In the Coverage form, <br />Schedule <br />Name of Parsonis) or Orgtnizatrons(sh <br />Any person or organization whom you have agreed In writing to add as an additional Insured, but only to coverage <br />and minimum limits of insurance requirsdoY the written agreement, and in no event to exceed either the scope of <br />coverage or the limits of Insurance provided In this pplloy. <br />Regarding Designated Contract or Project: <br />Each person er organization shown In the Schedule of this endorsement is an Insruarl" for Liability Coverage, but <br />only to the extent that person or orgaritzatiop qualifies as an "insured" under the Who is An Insured Provision <br />contained in Section 11 of the Coverage Form. <br />Thefolloving itedded to (he Other insurance Courcrition.- <br />It you have agreed in a written agreement that this policy Will be primary anti without right of ontributlon <br />from any Insurance in force for an Arditinaod'htatged for liability arising out of your operation.,, and the <br />agreement was executed prior to ths, "bodily Injury" or "property darrit than this insurance will be <br />primary stint we will not seek cophibution from such Insuranoea <br />Mvrz <br />Aumorl7ed Representative: _ <br />AC 84 23 (18 11 0 2010. Liberty Mutuel Group of Companies. All rights reserved, Page I of I <br />Includes copyrighted material of lasurance Services Office, ln% with its <br />permissrom <br />