|
<br />.
<br />3CN-25-2805 04:47 From:DPSI URNGURRD
<br />
<br />8055202525
<br />
<br />P.4/4
<br />
<br />'~A
<br />..,n~
<br />
<br />To:714 647 5406
<br />
<br />G-134S02-B
<br />(Ed. 06101)
<br />
<br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
<br />NON CONTRACTOR'S ADDlTION~L INSUREO ENDO.RSEMENT
<br />
<br />This andorsement modifies insurance provided under UI~ fulluwing:
<br />COMMERCIAL GENERAL LIABILITY COVERAGE PART
<br />
<br />An owner or other interest from whom land has
<br />baen leBsed by you hl)t only WiUl respect to
<br />liability arising out of the ownership,
<br />mainteMl1ce or Us~ of that specific part of Ihe
<br />
<br />, ytf5 ;; I/';;
<br />I, ./ ,_' .._._._M
<br />.. ...~ . .....-.-,--.--
<br />- .-,,_._~., _.,..-- '
<br />
<br />A. WHO IS AN INSURED (Section II) is amended to
<br />include liS ail insured ..ny person or organi~ation
<br />(called additional insured) described In paragraphs
<br />'1\.1.'through A.7. below whom you are requireq to
<br />. add as an additional insured on this policy under B
<br />wrlllf<n contract or written agreement; but tha written
<br />contract or written agreement must be:
<br />
<br />1. Currenlly in effect or becoming effective ouring
<br />the term of this policy; or
<br />
<br />2. Executed prior to the "bodily injury,' 'proptlrly
<br />damage' or '"",mon;;,1 Injury and advertlsing
<br />injury,' but
<br />
<br />Only 'the f~liowing persons or organizations are
<br />additional inSUred. und,,!! lhis endorsement and
<br />coverage provided to such additional Insureds is
<br />i1mlted as provided herein:
<br />
<br />1, ADDITIONAL INSURED STATE OR
<br />POLITICAL SUBDIVISIONS - PERMITS
<br />
<br />A state or political subdivision subject to the
<br />fallowing provisions;
<br />
<br />(aj This insurance applies only with respect to
<br />the following hazardS for which the etate or
<br />political subdivision has issued a permit in
<br />connection with premises you own, rent, or
<br />control and 10 which this insurance applies:
<br />
<br />(1) The existence, maintenance, repair,
<br />construction, F.Jrection. or removal of
<br />advertising signs, awnings, canopies,
<br />cellar entrances, coal holes. driveways,
<br />manholes, marquees, hOistaway
<br />openings, sidewalk vaults, street
<br />banners, Or decorations and similar
<br />exposures: or
<br />
<br />(2) The construction, erectioll, or removal
<br />of elevators; or
<br />
<br />(3) The ownership, maintenance, or use of
<br />any elevators covered by this insurance.
<br />
<br />(bl This insurance applies only with respect to
<br />operations performed by you or on your
<br />behalf for which the state or political
<br />subdivision has issued 0 permit
<br />
<br />ThiS insurance does not apply to "bodily injury,'
<br />"property damage" or "personal and adverti~ing
<br />injury" arising out of operations performed for
<br />the st<lte or municipality.
<br />
<br />G-134802-D
<br />(Ed. 06/01)
<br />
<br />2, ADDITIONAL INSURED - CONTROLUNG
<br />INTEREST
<br />Any parsons or org.miUltions with a controlling
<br />interest In you but only With respect 10 their
<br />liability arising out of;
<br />(a) Their financial control of vou; or
<br />(b) Premises they own, maintain or control
<br />while you Illose or occupy these premise..
<br />Tills insurance does not apply to structural
<br />alterations, new construction ano demolition
<br />operaticn~ performed by or for such additional
<br />insured,
<br />3. ADDITIONAL INSURED - MANAGERS OR
<br />LESSORS OF PRSMISES
<br />A manager or lessor of premises but only with
<br />respect to liability arising out of the ownership,
<br />maintenance or use of that specilic part of the
<br />premises leased to ynu and subject to the
<br />following additional exclusions:
<br />This insurance doas not apply to:
<br />(a) Any "occurrence" which lakes place after
<br />you cease to be a tenant in that premises;
<br />or
<br />(1)) Stl'uclural ~lb'rlItions, new construction or
<br />demolition operations performed by or on
<br />behaif of such additional insured.
<br />4. ADDITIONAL INSURED - MORTGAGEE,
<br />ASSIGNEE OR RECEIVER
<br />A mortgagee, assignee or receiver but only with
<br />respect to their liability as mortgegee, assignee,
<br />or receiver and ariSing out of the ownership.
<br />maintenence, or use of iii premises by you.
<br />This insurance does not apply to structural
<br />alterations, new ~onslruction or demolitiOn
<br />operations performed by or for such additional
<br />insured,
<br />
<br />5. ADDITIONAL INSURED _
<br />OTHER INTJ:ReSTS FROM
<br />HAS BEEN LEASED
<br />
<br />OWNERS OR
<br />WHOM LAND
<br />
<br />Page 1 of2
<br />
|