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Dr. Maureen Sassoon <br />EPW I 624061814 001 l ~ / ~ ~ / n q T° <br />Westchester Surplus Lines insurance Company <br />Insert the paUcy number. The remainder of iha Information ks to be completed only when this endorsement is Issued subsequent to the praparditon of the policy. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED ENDORSEMENT <br />OWNERS, LESSEES OR CONTRACTORS -SCHEDULED PERSON OR ORGANIZATION <br />This endorsement madifias insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE <br />CONTRACTOR'S POLLUTION LIABILITY COVERAGE <br />SCHEDULE: <br />Name of Person or Organizatlon: <br />Any person or organization that is an owner of real property or personal property on which you are <br />performing operations, or a contractor on whose behalf you are performing operations, and only at the <br />specific written request of such person or organization to you, wherein such request is made prior to <br />commencement of operations: <br />(If no entry appears above, information required to complete this endorsement will be shown In the Declarations <br />as applicable to this endorsement.) <br />A. SECTION it • WHO IS AN 1NSllRED is amended to include as an Insured the person or organization <br />shown In the Schedule, but only with respect to liability arising out of your ongoing operations <br />performed for that insured. <br />B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: <br />2. Exclusions <br />This insurance does not apply to bodily Injury or property damage occurring after <br />{1) All work, including materials, pads or equipment furnished in connection with such <br />work, on the project {other than service, maintenance or repairs) to be performed by or <br />on behalf of the additional insureds) at the si#e of the covered operations has been <br />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 #han another contractor or <br />subcontractor engaged in performing operations for a principal as a part of the same <br />project. <br />ENV~10D (08-1M) Includes copyrighted material of Insurance Services office, inc. vullh Its pannission Page 1 of 9 <br />