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DocuSign Envelope ID:484DA2FF-FF69-4942-ABET-1C7B9FE1C133 BROWBRO PAGE 2 <br /> NOTEPAD INSURED'S NAME Brown Brothers Plumbing and OP ID: DL ilatF: 1212212020 <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. <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. <br /> Contractors Pollution Liability: Self-Insured Retention $2,500. <br /> Contractors Pollution Liability: Includes Mold Liability at $2,000,000. <br /> limit. <br /> Contractors Pollution Liability: Mold deductible $2,500. <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 /> orkers Compensation. <br />