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2692015e0011500372 <br />Policy Number . AS2 -681- 004145 -726 <br />Issued by: Liberty Mutual Fire insurance Co. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED - NONCONTRISUTING <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIERS COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />moci fled by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who is An Insured <br />Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage form. <br />Schedule <br />Name of Persons) or Organlz�at4ons(s): <br />Any person or organization whom you have agresd in writing to add as an <br />additional, insured, but only to coverage and minimum limits of insurance <br />required by the Written agreement, and in no event to exyeed either the acope of <br />coverage or the limit$ of insurance provided in this pola.cy. <br />Regarding Designated Contractor Projects <br />Each person or organization shown in the Schedule of this endorsement is an "insured' for Liability Coverage, brit <br />ordy to the extent that person or organization qualifies as an " insured" under the Who is An Insured Provision <br />contained in Section 11 of the Coverage Form. <br />The following is addadto'the Other Insurance Condition: <br />tf you have agreed in a written agreement that this policy will be primary and % tlthout right of contribution <br />from as y Insurance in force for an Additional Insured for liability arising out of your operations, and the <br />agreement was executed prior to the "bodlly injury" or "property damage', then this insurance will ba <br />primary and we will not seek contribution from such Insurance, <br />AC 84 23 0811 0 2010, Liberty Mutual Croup of Companies. All rights reserved, Page 1 of 1 <br />Includes copyrighted material of Insurance Services Office. Inc., <br />with its peanIssien, <br />