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POLICY NUMBER: COMMERCIAL GENERAL LIABILITY <br /> CG20100413 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - OWNERS, LESSEES OR <br /> CONTRACTORS - SCHEDULED PERSON OR <br /> 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) Or Organization(s): <br /> THE CITY OF EVERETT, ITS OFFICERS, <br /> _ EMPLOYEES AND AGENTS <br /> 2930 WETMORE AVE <br /> - <br /> mierwerwass <br /> "'"��" EVERETT, WA 98201 <br /> Location(s) Of Covered Operations <br /> 1717 HEWITT AVE <br /> EVERETT, WA 98201 <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 B. With respect to the insurance afforded to <br /> include as an additional insured the person(s) these additional insureds, the following addi- <br /> or organization(s) shown in the Schedule, but tional exclusions apply: <br /> only with respect to liability for "bodily in- This insurance does not apply to "bodily in- <br /> jury", "property damage" or "personal and jury" or" property damage" occurring after: <br /> advertising injury" caused, in whole or in 1. All work, including materials, parts or <br /> pad' by. equipment furnished in connection with <br /> 1. Your acts or omissions; or such work, on the project (other than ser- <br /> 2. The acts or omissions of those acting on vice, maintenance or repairs) to be per- <br /> your behalf; formed by or on behalf of the additional <br /> in the performance of your ongoing oper- <br /> ations insured(s) at the location of the covered <br /> for the additional insured(s) at the Io- operations has been completed; or <br /> cation(s) designated above. 2. That portion of "your work" out of which <br /> However: the injury or damage arises has been put <br /> 1. The insurance afforded to such additional to its intended use by any person or or- <br /> insured only applies to the extent permit- ganization other than another contractor <br /> ted by law; and or subcontractor engaged in performing <br /> operations for a principal as a part of the <br /> 2. If coverage provided to the additional in- same project. <br /> sured is required by a contract or agree- <br /> ment, the insurance afforded to such <br /> additional insured will not be broader <br /> than that which you are required by the <br /> contract or agreement to provide for such <br /> additional insured. <br /> CG 20 10 04 13 0 Insurance Services Office, Inc., 2012 Page 1 of 2 <br />