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Policy Number: MGL0198215 Mt. Hawley Insurance Company <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />ADDITIONAL INSURED -OWNERS, LESSEES OR CONTRACTORS - <br />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): Locatlon(s) Of Covered Operations: <br />All persons or organizations where required All Locations <br />by a written contract executed prior to the <br />commencement of your work. <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 in- <br />clude as an additional insured the person(s) or organi- <br />zation(s) shown in the Schedule, but only with respect <br />to liability for "bodily injury", "property damage" or <br />"personal and advertising injury" caused, in whole or <br />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 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 />2. If coverage provided to the additional insured is <br />required by a contract or agreement, the in- <br />surance afforded to such additional insured will <br />not be broader than that which you are required <br />by the 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 re- <br />pairs) to be performed by or on behalf of the addi- <br />tional insured(s) at the location of the covered <br />operations has been completed; or <br />2. 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 04 13 © Insurance Services Office, Inc., 2012 <br />Insured <br />Page 1 of 2 <br />Docusign Envelope ID: B44A2432-4811-426C-B5F5-6E9650A4B84F