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Po 3'7, <br />A• a-O I `t • 2 3C-I � <br />OLD REPUBLIC GENERAL INSURANCE CORPORATION <br />CHANGES ADDITIONAL INSURED PRIMARY WORDING SCHEDULE <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />THIS ENDORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWING: <br />COMMERCIAL GENERAL LIABILITY COVERAGE FORM <br />Name of Additional Insured Person(s) Location(s) of Covered Operations <br />Or Organization(s): <br />Where required by written contract. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />The insurance provided by this endorsement is primary insurance and we will not seek contribution from <br />any other insurance of a like kind available to the person or organization shown in the schedule above <br />unless the other insurance is provided by a contractor other than the person or organization shown in the <br />schedule above for the same operation and job location. If so, we will share with that other insurance by <br />the method described in paragraph 4.c. of Section IV — Commercial General Liability Conditions. <br />All other terms and conditions remain unchanged. <br />Named Insured <br />T.E. Roberts, Inc. <br />Policy Number <br />AlCW13971800 <br />Endorsement No. <br />000 <br />Policy Period <br />09/01/2018 to <br />09/01/2019 <br />Endorsement Effective Date: <br />09/01/2018 <br />Producer's Name: <br />OLD REPUBLIC CONTRACTORS INSURANCE AGENCY, INC. <br />Producer Number: <br />0000007000 <br />AUTHORIZED REPRESENTATIVE <br />CG EN GN 0029 09 06 <br />DATE <br />011wlfs / P41< SAS <br />