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POLICY NUMBER: U21AC108719-03 COMMERCIAL GENERAL LIABILITY <br />CG 20 10 07 04 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />CG 20 10 07 04 © ISO Properties, Inc., 2004 Page 1 of 1 <br />ADDITIONAL INSURED – OWNERS, LESSEES OR 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 Additional Insured Person(s) <br />Or Organization(s):Location(s) Of Covered Operations <br />Any person or organization for whom you are performing <br />operations during the policy period when you and such <br />person or organization have agreed in writing in a contract <br />or agreement that such person or organization be added <br />as an additional insured on your policy. <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 <br />include as an additional insured the person(s) or <br />organization(s) shown in the Schedule, but only <br />with respect to liability for "bodily injury", "property <br />damage" or "personal and advertising injury" <br />caused, in whole or in part, by: <br />1.Your acts or omissions; or <br />2.The acts or omissions of those acting on your <br />behalf; <br />in the performance of your ongoing operations for <br />the additional insured(s) at the location(s) <br />designated above. <br />B.With respect to the insurance afforded to these <br />additional insureds, the following additional <br />exclusions apply: <br />This insurance does not apply to "bodily injury" or <br />"property damage" occurring after: <br />1.All work, including materials, parts or <br />equipment furnished in connection with such <br />work, on the project (other than service, <br />maintenance or repairs) to be performed by or <br />on behalf of the additional insured(s) at the <br />location of the covered operations has been <br />completed; or <br />2.That portion of "your work" out of which the <br />injury or damage arises has been put to its <br />intended use by any person or organization <br />other than another contractor or subcontractor <br />engaged in performing operations for a <br />principal as a part of the same project. <br />Docusign Envelope ID: 600E1FBD-8AF6-4F13-B95D-2B71C43F1FB3