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Hiscox Insurance Company Inc. <br />Policy Number: <br />Named Insured: <br />Endorsement Number: <br />Endorsement Effective: <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />CGL E5421 CW (02/14)Includes copyrighted material of Insurance Services Office, Inc., with its <br />permission. <br />Page 1 of 1 <br />ADDITIONAL INSURED –AUTOMATIC STATUS <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL GENERAL LIABILITY COVERAGE PART <br />A.Section II –Who Is An Insured is amended <br />to include as an additional insured any per- <br />son(s) or organization(s)for whom you are <br />performing operations or leasing a premises <br />when you and such person(s) or organiza- <br />tion(s) have agreed in writing in a contract or <br />agreement that such person(s) or organiza- <br />tion(s) be added as an additional insured on <br />your policy. Such person or organization is <br />an additional insured only with respect to lia- <br />bility for "bodily injury", "property damage" or <br />"personal and advertising injury" caused, in <br />whole or in part,by your acts or omissions or <br />the acts or omissions of those acting on your <br />behalf: <br />1.In the performance of your ongoing opera- <br />tions; or <br />2.In connection with your premises owned by or <br />rented to you. <br />A person's or organization's status as an addi- <br />tional insured under this endorsement ends <br />when your operations or lease agreement for <br />that additional insured are completed. <br />P103.390.218.2 <br />Civica Law Group APC <br />7 <br />05/15/2025 <br />Docusign Envelope ID: 77F58C49-597B-45D0-ADD1-C3C84EFB291D