Orange County NC Website
DocuSign Envelope ID: C9AF5D7E-E8F1-4FC2-8917-EA301453E701 <br /> POLICY NUMBER:M PU 13 7117' BUSINESSOWNERS <br /> BP 04 52 01 06 <br /> THIS ENDORSEMENT CHANIGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - STATE OR POLITICAL <br /> SUBDIVISIONS - PERMITS <br /> This endorsement modifies insurance provided under the following" <br /> BUSINESSOWNERS COVERAGE FORM <br /> SCHEDULE <br /> State Cr Political Subdivision: <br /> See BPM S At <br /> Information r2quired to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> The following is added to Paragraph C. Who Is An b. This insurance does not apply to: <br /> Insured in Section It—1-tability: (1) "Bodily injury", "property damage" or "per- <br /> 3. Any state or political subdivision shown in the sonal and advertising injury" arising out of <br /> Schedule is also an insured, subject to the f6low- operations performed for the state or mu- <br /> in provisions: nicipality; or <br /> a. This insurance applies only with respect to (2) "'bodily injury" or "'property damage" in- <br /> operations performed by you or on your behalf chided within the "products-completed op- <br /> for which the state or political subdivision has erations hazard". <br /> issued a permit. <br /> BP 04 52 01 06 0 ISO Properflos, Inc., 2004 Page 1 of 11 <br /> INSILHED COPY <br />