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POLICY NUMBER: NC.521567 COMMERCIAL GENERAL LIABILITY <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY, <br />DEDUCTIBLE LIABILITY INSURANCE <br />(including Allocated Loss Adjustment Expense) <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART <br />PRODUCTSICOMPLETED OPERATIONS LIABILITY COVERAGE PART <br />Coverage <br />Bodily Injury Liability <br />-OR- <br />Property Damage Liability <br />-OR- <br />Bodily Injury Liability and <br />Property Damage Liability Combined <br />SCHEDULE <br />Amount And Basis Of Deductible <br />PER CLAIM PER OCCURRENCE <br />-OR- $ <br />$ Soo <br />OR- $ <br />OR- $ <br />Not Applicable <br />-OR- $ <br />Not Applicable <br />A. Our obligation under the Bodily Injury Liability and Property Damage Liability Coverages to pay damages on <br />your behalf applies only to the amount of damages in excess of any deductible amounts stated in the <br />Schedule as applicable to such coverages. <br />B. You may select a deductible amount on either a per claim, a per "occurrence" or per item basis. Your selected <br />deductible applies to the coverage option and to the basis of the deductible indicated by the placement of the <br />deductible amount in the Schedule. The deductible amount stated in the Schedule applies as follows: <br />1. PER CLAIM BASIS. If the deductible amount indicated in the Schedule is on a per claim basis, that <br />deductible applies as follows: <br />a. Under Bodily Injury Liability Coverage, to all damages sustained by any one person because of <br />"bodily injury"; <br />Id. Under Property Damage Liability Coverage, to all damages sustained by any one person because of <br />"property damage"; or <br />c. Under Bodily Injury and Property Damage Liability Coverage Combined, to all damages sustained by <br />any one person because of: <br />(1) "Bodily injury"; <br />(2) 'Property damage"; or <br />(3) "Bodily injury" and "property damage" combined <br />as the result of any one 'occurrence". <br />If damages are claimed for care, loss of services, loss of support or death resulting at any time from <br />"bodily injury", a separate deductible amount will be applied to each person making a claim for such <br />damages. <br />With respect to "property damage", person includes an organization. <br />L850 (05109) Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 2 <br />