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POLICY NUMBER: 65471-57 COMMERCIAL GENERAL LIABILITY <br />CG 20 10 12 19 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED - OWNERS, LESSEES OR <br />CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />SCHEDULE <br />Name Of Addltional Insured Person(s) Or <br />Organlzatlon(s) <br />Location(s) Of Covered Operations <br />Any organization with whom you have agreed under written <br />All locations where you are performing work for such <br />contract, executed prior to loss, to include as an additional <br />additional Insured <br />insured with the specific terms set forth in this endorsement. <br />Such additional insureds will be reported to us on a quarterly <br />basis. Failure to report any speclflc additional insured will not <br />invalidate coverage hereunder provided the insured has <br />endeavored to report all additional insureds to the best of <br />their knowledge. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />A. Section II — Who Is An Insured is amended to include as <br />an additional insured the person(s) or organization(s) <br />shown in the Schedule, but only with respect to liability <br />for "bodily injury", "property damage" or "personal and <br />advertising injury" caused, in whole or in part, by: <br />1 Your acts or omissions; or <br />Z The acts or omissions of those acting on your <br />behalf; <br />In the performance of your ongoing operations for the <br />additional insured(s) at the location(s) designated <br />above. <br />However: <br />1 The insurance afforded to such additional insured <br />only applies to the extent permitted by law; and <br />Z If coverage provided to the additional insured Is <br />required by a contract or agreement, the insurance <br />afforded to such additional insured will not be <br />broader than that which you are required by the <br />contract or agreement to provide for such <br />additional insured. <br />B. With respect to the insurance afforded to these <br />additional insureds, the following additional exclusions <br />apply: <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring after: <br />1. All work, including materials, parts or equipment <br />furnished in connection with such work, on the <br />project (other than service, maintenance or repairs) <br />to be performed by or on behalf of the additional <br />Insured(s) at the location of the covered operations <br />has been completed; or <br />Z That portion of "your work" out of which the injury <br />or damage arises has been put to its intended use <br />by any person or organization other than another <br />contractor or subcontractor engaged in performing <br />operations for a principal as a part of the same <br />project. <br />CG 20 10 12 19 <'j, Insurance Services Office, Inc., 2018 Page 1 of 2 <br />