TIBURON INC. 4 - 2012 - Laserfiche WebLink

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Liability Insurance Endorsement Policy Period SEPTEMBER 1, 2011 TO SEPTEMBER 1, 2012 Effective Date APRIL 17, 2012 Policy Number 3591-10-23 LAO Insured GORES N-C HOLDINGS, LLC Name of Company FEDERAL INSURANCE COMPANY Date Issued APRIL 18, 2012 This Endorsement applies to the following forms: GENERAL LIABILITY LIABILITY GLOBAL EXTENSION Under Who Is An Insured, the following provision is added Who Is An Insured Additional Insured - Scheduled Person Or Organization APPROVED AS TO FORM Persons or organizations shown in the Schedule are insureds; but they are insureds only if you are obligated pursuant to a contract or agreement to provide them with such insurance as is afforded by this policy. However, the person or organization is an insured only: if and then only to the extent the person or organization is described in the Schedule; to the extent such contract or agreement requires the person or organizationto be afforded status as an insured; for activities that did not occur, in whole or in part, before the execution of the contract or agreement; and with respect to damages, loss, cost or expense for injury or damage to which this insurance applies. No person or organization is an insured under this provision: TERESA L. JU D Assistant City A rney that is more specifically identified under any other provision of the Who Is An Insured section (regardless of any limitation applicable thereto). with respect to any assumption of liability (of another person or organization) by them in a contract or agreement. This limitation does not apply to the liability for damages, loss, cost or expense for injury or damage, to which this insurance applies, that the person or organization would have in the absence of such contract or agreement. Liability Insurance Additional Insured - Sched x-ffAfigzt9wc ation continued Form 80-02-2367 (Rev. 5-07) Endorsement rr Page 1