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DocuSign Envelope ID: D5D06FFD-4F06-41F3-995C-9CC783787299 <br /> POLICY NUMBER: BN9 61618 COMMERCIAL GENERAL LIABILITY <br /> CG 2010 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 /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Organization(s): Locations Of Covered Operations <br /> ORANGE COUNTY <br /> PO BOX 8181 <br /> HILLSBOROUGH NC 27278 <br /> Information required to complete this Schedule, if not shown above,will be shown in the Declarations. <br /> A. Section li — Who Is An Insured is amended to B. With respect to the insurance afforded to these <br /> include as an additional insured the person(s) or additional insureds, the following additional exclu- <br /> organization(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' or <br /> damage" or "personal and advertising injury" 'property damage"occurring after: <br /> caused, in whole or in part, by: 1. All work, including materials, parts or equip- <br /> 1. Your acts or omissions; or ment furnished 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 location of the <br /> the additional insured(s) at the location(s) desig- covered operations has been completed; or <br /> nated above. 2. That portion of "your work" 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 contractor or subcontractor en- <br /> gaged in performing operations for a principal <br /> as a part of the same project. <br /> CG 20 110 07 04 ©ISO Properties, Inc.,2004 Page 1 of 1 13 <br />