Laserfiche WebLink
)� SCOTTSDAI.E INSURANCE COMPANY <br />ENDORSEMENT <br />NO. <br />ATTACHED TO AND <br />ENDORSEMENT EFFECTIVE DATE <br />FORMING APART OF <br />(12:01 A.M. STANDARD TIME) <br />NAMED INSURED <br />AGENTNO. <br />POLICY NUMBER <br />CPS1111583 <br />02i02i2010 <br />PACIEIC SYSTEMS ELECTRIC <br />04058 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -OWNERS, LESSEES OR <br />CONTRACTORS SPECIAL CONDITION <br />If any of the endorsements below are attached to this policy, coverage provided by the additional insured <br />endorsement is amended to be afforded on a primary, noncontributory or primary and noncontributory <br />basis when and as agreed to in writing in a contract or agreement between you and the additional insured. <br />Additional Insured - Owners, Lessees Or Contractors - Scheduled Person Or Organization (CG 20 10) <br />Additional Insured - State Or Political Subdivisions - Permits (CG 20 12) <br />Additional Insured - Owners, Lessees Or Contractors - Automatic Status When Required In Construc- <br />tion Agreement With You (CG 20 33) <br />Additional Insured - Owners, Lessees Or Contractors - Completed Operations (CG 20 37) <br />Other: (Specify title and form number) <br />GLS -295s (7-08) <br />AUTHORIZED REPRESENTATIVE <br />Pagel of <br />INSURED <br />DATE <br />g1s295s. fep <br />