SASSOON, MAUREEN, DR., MS, MPH - Laserfiche WebLink

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Named Insured Endorsement Number Dr. Maureen Sassoon Poky Symbol Polley Numbor policy poriod Effective Date of Endorsement ECP G24270427 008 07/01/2019 to 07/01/2020 07/01/2019 Issued By (Name of Insurance Company) Westchester Surplus Lines Insurance Company mean me panty number. The nemelnder of the Imormetion is to be completed only when this endonemeol Is Issued subsequent to the preperallan of me policy. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART CONTRACTORS POLLUTION LIABILITY COVERAGE PART SCHEDULE Nome of Person or Omanizoliorr Any person or organization that is an owner of real property or personal property on which you are performing operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of such person or organization to you, wherein such request is made prior to commencement of operations. (If no entry appears above, information required to complete this endorsement wit be shown in the Declarations as applicable to this ouwreenieut./ The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition is amended by the addition of the following: We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or your work done under a contract with that person or organization and included in the products -completed operations hazard. This waiver applies only to the person or organization shown in the Schedule above. All other terms and conditions remain the same. REVIEWED & APPROVED By Risk MANAGEMENT DIVISION U 17 2019 FRANCINE R. VILLAREAL ENV-3143 (03A5) Includes copyrighted material of Insurance Services Office, Inc. with Its permission Page 1 of 1