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POLICY NUMBER; HDO G27413311 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />ADDITIONAL INSURED — OWNERS, LESSEES OR <br />CONTRACTORS (FORM B) <br />This endorsement modifies Insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or Organization; ANY OWNER, LESSEE OR CONTRACTOR WHOM YOU HAVE <br />AGREED TO INCLUDE AS AN ADDITIONAL INSURED UNDER A WRITTEN CONTRACT, PROVIDED <br />SUCH CONTRACT WAS EXECUTED PRIOR To THE DATE OF LOSS. <br />(if no entry appears above, information required to complete this endorsement would be <br />shown in the Declarations as applicable to this endorsement.) <br />WHO IS AN INSURED (Section il) Is amended to include as an insured the person or <br />organization shown In the Schedule, but only with respect to liability arising out of "your <br />work" for that insured by or'for you. <br />CG 20 10 11 85 Copyright, Insurance Services Office, Inc., 1984 <br />AM7ohmeaf Code: D446557 <br />MastorLD; 1366006, Certificate rD: 1107d601 <br />REVIEWED BY: _EUrJICE HER_D1.1 (aG 2OFS ) <br />