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EXCEL PAVING CO. 15-6836 & 15-6452 REVIEWED BY: ' EUNICE HEREDIA (PG 6 OF 7) <br />OLD REPUBLIC GENERAL INSURANCE CORPORATION <br />'CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE REAL) IT CAREFULLY, <br />THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: <br />COMMERCIAL GENERAL QAfdIL17Y COVERAGE FORM <br />Name of Addlfibnal Insured Persons) <br />Or Orgagizatipn(s): <br />As roquuod by wrltton contract. <br />Location(s) of Covered Operations <br />Information required.0 complete this Schedule, Ifoot shown above, will be shown 'Inthe Declarations; <br />The Insurence provided by this endorsomemt Is primary insurance and we will not seek contribution from <br />any other Insurance of a like kind available kb the person or organization shown In the schedule ahove <br />unless the other Insuranas is provided by a contractor othorihon tireparson.or organization shown In tine <br />schedule above for the some operation and job.locaflon. It so, we will sham with that otherlosurenoe by <br />the method described In paragraph 4.o, of Section IVB -Commercial General Liability Conditions. <br />All ofharterrms and conditions remain unchanged, <br />Named Insured <br />Pulp, Inc. dba Excel Paving Company <br />Policy Number <br />A1CG50211511 <br />00/0112015-06/0112016 <br />`Sndursemont No. <br />Polioy Period <br />Endoraerr)ent Enectiva Data: <br />_ <br />05/01/2015 <br />Producei's Nama: <br />Old Republic Constructlon Insurance Agency Inc, <br />-- <br />ProducerNnYtlhefi <br />�_-��---- <br />AU`rHOR12Ep REPRESENTATIVE <br />CG EN GN 0029 09 06 <br />0510112.016 <br />DATE <br />