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POLICY NUMBER: PAS037663755 COMMERCIAL GENERAL LIABILITY <br /> CG 20 10 07 04 <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 /> • <br /> • <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Organization(s): Location(s) Of Covered Operations <br /> Snohomish County,its officers,elected officials, All locations <br /> agents and employees <br /> Information required to complete this Schedule, if not shovvn above,will be she ,n in the Declarations. <br /> A. Section II Wio Is An Insured is amended in B. With respect to the insurance afforded In these <br /> include as an additional insured the person(s) or additional insureds,the follovving additional exclu— <br /> organ¢ation(s) shown in the Schedule, but only sions apply: <br /> with respect to liability-for"bodily injury', "property This insurance does not apply to 'bodily injury" cr <br /> . damage" or 'personal and advertising injury" "property damage"occurring atter: <br /> caused, in whole or in part, by: <br /> 1. All work, including materials, parts or equip- <br /> 1. Your acts or omissions; or ment -famished in connection with such work, <br /> 2. The acts or omissions of those acting on your on the project (other than service, maintenance <br /> behalf or repairs) to be performed by or on behalf of <br /> in the performance of your ongoing operations for the additional insured(s) at the bcation of the <br /> the additional insured(s) at the bcation(s) desig— <br /> covered operations has been mmplc ted;or <br /> nated above. 2. That portion of'your wont' out of which the <br /> injury or damage arises has been put to Its in— <br /> tended use by any person or organization other <br /> than another cor ib actor or subcontractor en— <br /> gaged in performing operations for a principal <br /> as a part ofthe same project <br /> • <br /> CG 20 10 07 04 Copyright; ISO Properties, Inc., 2004 Page 1 of 1 ,❑ <br />