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THIS ENDORSEMENT CHANGES THE POLICY. …

policy NUMBER: COMMERCIAL GENERAL LIABILITY. CG 20 10 04 13. this ENDORSEMENT CHANGES THE policy . PLEASE READ IT CAREFULLY. ADDITIONAL INSURED OWNERS, LESSEES OR. CONTRACTORS SCHEDULED PERSON OR. ORGANIZATION. this ENDORSEMENT modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE. Name Of Additional Insured Person(s). Or Organization(s) Location(s) Of Covered Operations MUST LIST ALL ENTITIES PRECISELY! IF NOT ALL LOCATIONS FOR XYZ ENTITY(IES). LISTED, THEY ARE NOT COVERED! Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Page 2of 2 © Insurance Services Office, Inc.,2012 CG 20 10 04 13 C.With respect to the insurance afforded to these additional insureds, the following is added to

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