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POLICY NUMBER: 0426_70_158 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) Location(s) Of Covered Operations <br /> ANY PERSON OR ORGANIZATION WHOM YOU PER THE CONTRACT OR AGREEMENT <br /> BECOME OBLIGATED TO INCLUDE AS AN <br /> ADDITIONAL INSURED AS A RESULT OF ANY <br /> CONTRACT OR AGREEMENT YOU HAVE ENTERED <br /> INTO. <br /> Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> CG 20 10 12 19 0 Insurance Services Office, Inc., 2018 Pagel of 2 ❑ <br />