L.M. Sundholm Inc. PS 9/4/2020 - Laserfiche WebLink

L.M. SUNDHOLM, INC.DBA SILVER LAKE EYE CARE CENTER POLICY NUMBER: BZS58883076 BUSINESSOWNERS BP 04 52 07 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: BUSINESSOWNERS COVERAGE FORM SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: The City of Everetr_ 2930 WeLmore Ave. , SLe. 8-A EvereLL, WA 98201 S Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Section II-Liability is amended as follows: b. This insurance does not apply to: A. The following is added to Paragraph C. Who (1) "Bodily injury". "property dam- Is An Insured: age" or "personal and advertis- M 3. Any state or governmental agency or ing injury" arising out of subdivision or political subdivision operations performed for the shown in the Schedule is also an addi- federal government, state or mu- tional insured, subject to the following nicipality; or provisions: (2) "Bodily injury" or "property a. This insurance applies only with re- damage" included within the spect to operations performed by "products-completed operations you or on your behalf for which the hazard". state or governmental agency or sub- B. With respect to the insurance afforded to division or political subdivision has these additional insureds, the following is issued a permit or authorization. added to Paragraph D. Liability And Medical However: Expenses Limits Of Insurance: (1) The insurance afforded to such If coverage provided to the additional insured additional insured only applies is required by a contract or agreement, the to the extent permitted by law; most we will pay on behalf of the additional and insured is the amount of insurance: (2) If coverage provided to the addi- 1. Required by the contract or agreement; tional insured is required by a or contract or agreement, the insur- 2. Available under the applicable Limits Of ance afforded to such additional Insurance shown in the Declarations; insured will not be broader than whichever is less. that which you are required by This endorsement shall not increase the ap- the contract or agreement to pro- plicable Limits Of Insurance shown in the vide for such additional insured. Declarations. BP 04 52 07 13 © Insurance Services Office, Inc., 2012 Page 1 of 1