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2122 01 4000077wQ91 <br />Policy Number TB2681004145715 <br />Issued by Liberty Mutual Fire Insurance Co, <br />THIS END ORSEVENT CHANGES THE POLICY. PLEASE READ ITCAREFULLY. <br />This endorsement modifies insurance provided under the following: <br />SECTION 11- WHO 15 ANINSURED is amended to include as an insured any person or organization for whom you <br />have agreed in writing to provide liability insurance. But: <br />The insurance provided by this amendment: <br />1. Applies only to 'bodily injury or'property damage' arising out of (a) 'your work* or (b) premises or other <br />property owned by or rented to you; <br />Z Applies only to coverage and minimum limits of insurance required by the written agreement, but in no event <br />exceeds either the scope of coverage or the limits of insurance provided by this policy; and <br />3,- Does not apply to any person or organization for whom you have procured separate liability insurance while <br />such insurance Is in effect, regardless of whether the scope of coverage or limits of insurance of this policy <br />exceed those of such other insurance or whether such other insurance is valid and collectible, <br />The following provisions also apply: <br />1. Where the applicable written agreem erd requires the insured to provide liability insurance on a primary, excess, <br />contingent, or any other basis, this policy will apply solely on the basis required by such written agreement and <br />Rtm 4. Other Insurance of SECTION IV of this policy will not apply. <br />2. Where the applicable written agreement does not specify on what basis the liability insurance will apply, the <br />provisions of Item 4. Other Insurance of SECTION IV of this policy will govern- <br />3 This endorsement shall not apply to any person or organization for any "bodily injury' or "property damage" if <br />any other additional insured endorsement on this policy applies to that person or organization with regard to the <br />*bodily injury' or *property damage'. <br />4. If any other additional insured endorsement applies to any person or organization and you are obligated under <br />a written agreement to provide liability insurance on a pnimary, excess. contingent or any other basis for that <br />additional insured, this policy will apply solely on the basis required by such written agreement and item 4. <br />Other Insurance of SECTION IV of this policy will not apply, regardless of whetherthe person or organization <br />has available other valid and collectible insurance. If the applicable written agreement does not specify on <br />what basis the liability insurance will apply, the provisions of item 4. Other Insurance of SECTION rV of this <br />policy will govern. <br />LN 2001 0605 <br />