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DocuSign Envelope ID: 1A2F6F38-EEE5-4E08-B32B-FD2AF5679B8C <br /> NOTEPAD - �BROWBRO - PAGE z <br /> INSURIZUSNAME Brown Brothers Plumbing and OP ID: DL Dale 1110712017 <br /> The following forms apply if required by written/executed contract, before <br /> a loss: <br /> dditional Insured for General Liability ongoing & Completed Operations <br /> and Primary & Non Contributory wording: CG7034(07/DCo Ceted4(perat and <br /> CG2001(4/13) , <br /> Blanket Additional Insured applies to Contractors Pollution Liability for <br /> Ongoing & Completed Operations, when required by written contract, per <br /> £CC3200712 and ECC5480712. <br /> Designated Insured for Auto Liability; CA2048 (02/99) . <br /> Blanket Waiver of Subrogation for General Liability: CG7051 (06/15) . <br /> Blanket Waiver of Subrogation for Workers Compensation: WC 000313 (04/84) <br /> Blanket Waiver of Subrogation for Contractors Pollution Liability: per <br /> ECC3190712. <br /> Contractors pollution Liability: Self Insured Retention $1o,000. <br /> Contractors Pollution Liability: Mold deductible $25,000. <br /> Umbrella follows form, for General Liability, Automobile Liability & <br /> Workers Compensation. <br /> A.M. Aest Rating A. <br /> I <br />