Laserfiche WebLink
Endorsement No. _ <br /> Effective Date: 0 810 1/2 01 9 @12:01 a.m.Standard Time at the address of the Named Insured <br /> Policy Number: SP002682-03-2019 <br /> Insured Name: Gregg Drilling,LLC I <br /> Issuing Company:AXIS Surplus Insurance Company <br /> Additional(Return)Premium: m <br /> If the Endorsement Effective Dote is blank,then the effective dote of this Endorsement is the Inception Dote of the Policy. <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> ORGANIZATION <br /> OOaOidormolmodilminlErMco:rodd-d old r ollo❑inCt <br /> ❑PCC-P DO PGC❑❑❑❑POCL❑ <br /> SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Organization(s) Location(s) Of Covered Operations <br /> W-s-r--drCd Cy 11riu7n conmCccor mEE[:]oldn <br /> -:::c nor [0 my cimd cid❑ <br /> mmro Mon r-[IrCd [o coo d®1110 ccC(-ddMoloQo❑n 2o[I:mill m Ma❑n in Imp❑CclErEftn❑ <br /> A Section III - Who Is An Insured i _-'-nd-d o B. Wi r-T c llo ® in[ErMc❑ Enordr-d io <br /> inclEd❑ U In Cddi ion I in i r d r on - or ddi ion I ini-rCom FFTi [ollo❑in❑ Cddi[bnd <br /> or❑—nimiton=Er-oi-n in u- -a--dL]-i= -only cl ion -Jy: <br /> ❑i®r=3-c❑m liMli[y [or Bodily Injury, Property i in r nc:1domnoE-dy 10 Bodily Injury or <br /> Damage or Personal And Advertising Injury Property Damage occ[rrin❑G®: <br /> c d[In ❑Eoloorin m=y: <br /> 1. coo- Ccmoro❑imon❑Ebr 1. -11 -or11 inc ❑C�idm m or <br /> L�-iiz7O1❑�ni=�id in connEcGon ❑i® mc0 <br /> 2. om CcEM or o❑ikon❑o❑mom Ccfih❑on your ❑orm on ® Uro1-c❑ mOm' 11:h m dcm <br /> �all ❑dnlmiMc❑or rimlrmm m ISrmro Ed Cy or <br /> in ®iv mro❑1c❑o❑yoLr onCoin❑omEion❑[or on FFM000= CddiTon❑ inEE Cdlai7 m FIFVI <br /> ffFFi Cddiaond inmr_rd® m ® loccibnEEn IOCClbn on I)m com-Cd olarnfon❑ F-m D:En <br /> dmotl=d abm con dlEdCor <br /> ❑o❑pm: 2. ❑®Corlbn o❑Your Work omon❑lco <br /> 1. om inmolc❑ --ord-d o zc❑ EddiGond inky or dm u = oim ® met ®D i® <br /> inandCd m Ey My E,::rF-on or ormtimibn <br /> inmCd only Cdi__ o -- zm--:r❑iEiEd Gy o, „ a-]t LtoUJ conlilEc(Dr or mconfEc[br <br /> ICom1d o1m-d in Lorior❑in❑ oE1]rdbn11 mr ❑ <br /> 2. I]LcoEEmoroldA0 _ -ddiion-IinFirCdi❑ oinciMEDE] -r_o®=oErollc❑ <br /> rIrFd F-Y ❑ conr-c- or --r- iAi31m = <br /> in-Fr-nc- --ord-d -o =-c[- -ddi ion-] inmrd <br /> All no -ro d r -n - -ic7 yoo Er[] <br /> rMJr-d ry Li - con,c c or r=ME] ro <br /> Erodd or Lau i-ddi ion 1 in i r d. <br /> Includes copyrighted material of Insurance Services Office,Inc with its permission <br /> CG 20 10 0413 <br /> SPP 2010 13(02 14) Page 1 of 2 <br /> 51017096 19-20 GL-A=-WC-%S-CPL-PROP I Phyllis Johnson 1 9/6/2019 2:23:12 PM (PVP) I Page 11 of 14 <br />