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PAGENOTEPADINSURED'S NAME Date <br />BROWBRO 2 <br />Brown Brothers Plumbing and OP ID: KB 12/28/2023 <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 /> <br />Blanket Additional Insured applies to Contractors Pollution Liability for <br />Ongoing & Completed Operations, when required by written contract. <br /> <br />Designated Insured for Auto Liability: CA2048(10/13). <br /> <br />Blanket Waiver of Subrogation for General Liability: CG7051(06/15). <br /> <br />Blanket Waiver of Subrogation for Workers Compensation: WC 000313(04/84). <br /> <br />Blanket Waiver of Subrogation for Contractors Pollution Liability. <br /> <br />Contractors Pollution Liability: Self-Insured Retention $2,500. <br />Contractors Pollution Liability: Includes Mold Liability at $2,000,000. <br />limit. <br /> <br />Contractors Pollution Liability: Mold deductible $2,500. <br /> <br />Excess liability policy over Professional/Pollution Liability Policy <br />$1,000,000. Lloyds of London-Policy #EL00-53-0070-2022 (Effective <br />06/03/2023-06/03/2024.) <br /> <br />Blanket Additional Insured on Automobile Liability, with Primary and <br />Non-contributory wording, per attached form CA3000(07/14). <br /> <br />Umbrella follows form for General Liability, Automobile Liability and <br />Workers Compensation. <br /> <br />**Contractors Rented/Leased Equipment is $250,000 subject to a $1,000 <br />Deductible. Effective 12/31/2023 to 12/31/2024 under policy number <br />PCP000005515.** <br />DocuSign Envelope ID: 98BBF9B0-744C-418E-8FE2-511FF4334E70