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Named Insured <br />Endorsement Number <br />Dr. Maureen Sassoon <br />Policy Symbol <br />Policy Number <br />Policy Period <br />Effective Date of Endorsement <br />ECP <br />624270427 004 <br />07/01/2015 to 07101/2016 <br />07/0112015 <br />Issued By (Name of Insurance Company) <br />Westchester Surplus Lines Insurance Company <br />Intent the policy number. The remainder of the information is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />CONTRACTORS POLLUTION LIABILITY COVERAGE PART <br />SCHEDULE <br />Name of Person or orcanizetion: <br />Any person or organization that Is an owner of real property or personal property on which you are performing <br />operations, or a contractor on whose behalf you are performing operations, and only at the specific written request of <br />such person or organization to you, wherein such request is made prior to commencement of operations. <br />If no entry appears above, Information required to complete this endorsement will be shown in the Declarations as annlirahla to this <br />endorsement.) <br />The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condition Is amended by the addition of the <br />following: <br />We waive any right of recovery we may have against the person or organization shown In the Schedule above because of <br />payments we make for Injury or damage arising out of your ongoing operations or your work done under a contract with <br />that person or organization and Included in the products•completed operations hazard. This waiver applies only to the <br />person or organization shown in the Schedule above. <br />All other terms and conditions remain the same. <br />ENV -3143 (03 -05) Includes copyrighted material of Insurance Services Office, Inc. with its permission <br />Pagel of I <br />q I�' <br />