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DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373A05897A <br /> BROwBRO PAGE 2 <br /> NOTEPAD <br /> INSUREUS NAME Brown Brothers Plumbing and OP ID: DL Date 05/07/2019 <br /> The following forms apply if required by written/executed contract, before <br /> a loss: <br /> Additional Insured for General Liability Ongoing & Completed Operations <br /> and Primary & Non-contributory wording: CG7034 (07/09) , CG7024(03/09) 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 /> ECC3190712 and ECC5480317. <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 /> ECC3200712. <br /> Contractors Pollution Liability: Self Insured Retention $10,000. <br /> Contractors Pollution Liability: Mold deductible $25,000. <br /> Blanket Additional Insured on Automobile Liability, with Primary and <br /> Non-contributory wording, per attached form CA3000(07/14) . <br /> Umbrella follows form for General Liability, Automobile Liability and <br /> Workers Compensation. <br /> A.M. Best Rating A. <br />