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POLICY NUMBER: HDO G27403311 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 PRIOR70 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 II) 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 />AtWohmont Codd: D4116557 <br />Maitoi,JD: 1306000, Certiflcah, IDf 11076601 <br />REVIEWED BYG-P� %' f,�%� EUNICE HEREDIA (PG �—OF3 <br />