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Forms a part of Policy No.: EV20230202-03 <br /> Issuing Company: Capitol Specialty Insurance Corporation <br /> Additional Insured — Owners, Lessees or Contractors — Scheduled Person or <br /> Organization <br /> Continued <br /> If this endorsement is issued after the Policy has been issued, it is deemed to have been added to the list of forms and endorsements <br /> on the Declarations. <br /> All other terms and conditions of this Policy remain unchanged. ,:,--z <br /> Authorized Representative <br /> ENV 167(05-16) 0 2016 CapSpecialty,Inc.All rights reserved. Page 2 of 2 <br />