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POLICY NUMBER: 360-93-69 COMMERCIAL GENERAL LIABILITY <br />CG20101219 <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 Organization(s) Locations Of Covered Operations <br />PARTIES CONTRACTED FOR ADDITIONAL PER THE CONTRACT OR AGREEMENT <br />INSURED STATUS <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II — Who Is An Insured is amended to B. With respect to the insurance afforded to these <br />include as an additional insured the person(s) or additional insureds, the following additional <br />organization(s) shown in the Schedule, but only exclusions apply: <br />with respect to liability for "bodily injury", "property This insurance does not apply to "bodily injury" ordamage" or "personal and advertising injury" property damage" occurring after:caused, in whole or in part, by: <br />1. All work, including materials, parts or <br />1. Your acts or omissions; or equipment furnished in connection with such <br />2. The acts or omissions of those acting on your work, on the project (other than service, <br />behalf; maintenance or repairs) to be performed by or <br />in the performance of your ongoing operations for on behalf of the additional insured(s) at the <br />the additional insured(s) at the location(s) location of the covered operations has been <br />designated above.completed; or <br />However: 2. That portion of "your work" out of which the <br />1. The insurance afforded to such additional <br />injury or damage arises has been put to its <br />intended use by any person or organization <br />insured only applies to the extent permitted by other than another contractor or subcontractor <br />law; and engaged in performing operations for a <br />2. If coverage provided to the additional insured is principal as a part of the same project. <br />required by a contract or agreement, the <br />insurance afforded to such additional insured <br />will not be broader than that which you are <br />required by the contract or agreement to <br />provide for such additional insured. <br />oR,N <br />F <br />RiskMougementDMslcrn <br />a REVIEWED&APPROVED BY. <br />tq t ceva o <br />J Risk Management Specialist <br />CG 20 10 12 19 Insurance Services Office, Inc., 2018 Page 1 of 2