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DocuSign Envelope ID:91 F43AFA-8CB4-4861-887A-F304C7A6614B <br /> POLICY NUMBER: COMMERCIAL GENERAL LIABILITY <br /> CG 20 12 07 98 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - <br /> STATE OR POLITICAL SUBDIVISIONS - PERMITS <br /> This endorsement modifies insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> State Or Political Subdivision: <br /> Any State or Political Subdivision that issues a permit to the named insured. <br /> (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as <br /> applicable to this endorsement.) <br /> Section II — Who Is An Insured is amended to 2. This insurance does not apply to: <br /> include as an insured any state or political subdivi- a. "Bodily injury," "property damage"or"personal <br /> sion shown in the Schedule, subject to the following and advertising injury" arising out of opera- <br /> provisions: tions performed for the state or municipality; <br /> 1. This insurance applies only with respect to opera- or <br /> tions performed by you or on your behalf for b. "Bodily injury" or "property damage" included <br /> which the state or political subdivision has issued within the "products-completed operations <br /> a permit. hazard". <br /> CG 20 12 07 98 Copyright, Insurance Services Office, Inc., 1997 Page 1 of 1 ❑ <br />