2011-355 SW - Patriot Building Company, Inc. for recycling concrete pad

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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM All of the terms, provisions,exclusions, and limitations of the coverage form apply except as specifically stated below. Policy Number Agency Number Policy Effective Date CPP 2048089 81-6396-150 09/01/2011 Policy Expiration/Cancellation Date Date Account Number 09/01/2012 09/08/2011 10815503 Named Insured Agency Issuing Company PATRIOT BUILDING COMPANY INC TRISURE CORPORAITON AMERISURE INSURANCE CO 1. SECTION II-WHO IS AN INSURED is amended to add as an insured any person or organization: a. Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business; or b. Who is named as an additional insured under this policy on a certificate of insurance. However,the written contract,written agreement or certificate of insurance must require additional insured status for a time period during the term of this policy and be executed prior to the"bodily injury", "property damage", or"personal and advertising injury"giving rise to a claim under this policy. If, however, "your work"was commenced under a letter of intent or work order, subject to a subsequent reduction to writing within 30 days from such commencement and with customers whose customary contracts require they be named as additional insureds,we will provide additional insured status as specified in this endorsement. 2. SECTION II-WHO IS AN INSURED is amended to add the following: If the additional insured is: a. An individual, their spouse is also an additional insured. b. A partnership or joint venture, members, partners, and their spouses are also additional insureds. c. A limited liability company, members and managers are also additional insureds. d. An organization other than a partnership,joint venture or limited liability company, executive officers and directors of the organization are also additional insureds. Stockholders are also additional insureds, but only with respect to their liability as stockholders. e. A trust,trustees are also insureds, but only with respect to their duties as trustees. 3. The insurance provided to the additional insured under this endorsement is limited as follows: a. That person or organization is only an additional insured with respect to liability arising out of: (1) Premises you own, rent, lease,or occupy;or (2) Your ongoing operations, unless the written contract,written agreement or certificate of insurance also requires completed operations coverage (or wording to the same effect), in which case the coverage provided shall extend to your completed operations for that additional insured. Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 1109 Page 1 of 3