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Named Insured <br />Endarsemont Number <br />Dr. Maureen Sassoon <br />Pollry Symbol <br />Policy Number Policy period <br />Effective Date 7 Endorsement <br />EGP <br />1 1 07101/2016 to 07/01/2017 <br />07/0112016 <br />Issued By (Name of Insurance Company) <br />Westchester Surplus Lines insurance Company <br />Insertthe polIGV number. The remainders€ the information to lobe complated Only when this endorsement is issued uubwqumlt to the pralwrnHon of tris 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 />NISMS of tie rson or Organization, <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 prier to commencement of operations. <br />(if no entry appears above, information required W complete znis enQQrseM8nL Will vr5 bnuw,I [„ uin uCLra1auU1/a as OppE.,,aU1G av u <br />endorsement_) <br />The TRANSFER OF RIGHT'S 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 beoausa 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 operatlons 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 />A3 <br />ENV -3143 (03-05) Includes capyrigNed MWed3l of InSvranGa Services Office, Ins. with its permission Page f of 1 ?_% " <br />