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Named Insured <br />Endorsement Number <br />Dr. Maureen Sassoon <br />Policy Symbol <br />Policy Number Policy Period <br />Effective nate of Endorsement <br />ECP <br />624270427 006 0710112017 to 07/01/2018 <br />07101/2017 <br />Issued By (Name of Insurance Company) <br />Westchester Surplus Lines Insurance Company <br />Insert the policy number. The remainder ofthe information is to be completed only whenthis 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 PANT <br />SCHEDULE <br />Name of Person or O anization: <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 />i s IIW L711LIy aPNea1a :aUUVe, mioirrration requirea to complete tnls endorsement will be shown in the Declarabons as applicable to this <br />endorsement) <br />The TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US Condlf'ton 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 tate 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. uvith its permission <br />t IV <br />Page I of 1 <br />