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Policy Number: EMP1900099806 <br />COMMERCIAL <br />GENERAL LIABILITY <br />CG 20 10 07 04 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR <br />ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Additional Insured Person(s) <br />Or Or anization s : <br />Locations Of Covered Operations <br />Any person(s) or organization(s) whom the Named <br />Insured agrees, in a written contract, to name as an <br />Additional insured. However, this status exists only <br />Tor the project specified in that contract. <br />Information required to complete this Schedule, if not shown <br />above, will be shown in the Declarations. <br />A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or <br />organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property <br />damage" or "personal and advertising injury" caused, in whole or in part, by: <br />1. Your acts or omissions; or <br />2. The acts or omissions of those acting on your behalf; <br />in the performance of your ongoing operations for the additional insured(s) at the location(s) <br />designated above. <br />B. With respect to the insurance afforded to these additional insureds, the following additional <br />exclusions apply: <br />This insurance does not apply to "bodily injury" or "property damage" occurring after: <br />1. All work, including materials, parts or equipment furnished in connection with such work, on <br />the project (other than service, maintenance or repairs) to be performed by or on behalf of the <br />additional insured(s) at the location of the covered operations has been completed; or <br />2. That portion of "your work" out of which the injury or damage arises has been put to its <br />intended use by any person or organization other than another contractor or subcontractor <br />engaged in performing operations for a principal as a part of the same project. <br />orz,N�F RiskMougementDMsian <br />r' REVIEWED & APPROVED BY. <br />x <br />® Risk Management Specialist <br />CG 20 10 07 04 <br />