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DocuSign Envelope ID:C5AE60ED-3944-4BD4-888D-03C35A9C4941 <br /> INTERLINE <br /> POLICY NUMBER; SP869601 <br /> N : EVAN STAN INSURANCE COMPANY <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED ENDORSEMENT <br /> This endorsement modifies insurance provided under the following: <br /> GENERAL LIABILITY (INCLUDING PRODUCTS AND COMPLETED OPERATIONS LIABILITY) INSURANCE POLICY <br /> In consideration of the premium paid, it is hereby understood and agreed that the policy is arnended as follows-. <br /> 1. Section THE INSURED, is amended by the addition of the following: <br /> Whenever used in this policy, the unqualified word Insured shall also mean Additional Insured. <br /> 2. Additional Insured, whenever used in this endorsement, shall mean the following <br /> Orange County Government <br /> 3. Designated Premises,whenever used in this endorsement, shall mean the following: <br /> 131 W, Margaret Lane, <br /> Suite 300 <br /> Hillsborough, NC 27278 <br /> 4. Coverage provided to any Additional Insured as defined herein shall apply solely: <br /> (a) to Claims first made against the Insured during the Policy Period or any extended reporting period, if purchased; <br /> (b) for Claims arising out of the Named Insured's occupancy of, or failure to maintain, the Designated Premises, but <br /> solely with respect the products, goods or operations of the Named Insured and only if liability for such Claim is <br /> determined to be solely the negligence or responsibility of the Named Insured; and <br /> (c) for Occurrences at, on or upon that portion of the Designated Premises which is occupied by the Named Insured. <br /> All other terms and conditions remain unchanged <br /> EIC 43721 04 Page 1 of 1 <br />