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POLICY NUMBER:A0080216004 <br />ADDITIONAL INSURED - SUPPLEMENTAL DECLARATIONS <br />The following persons or organizations are included as Additional Insureds, but only to the extent provided in <br />the listed endorsement: <br />Any person or organization you are required to add as an <br />additional insured under a written contract or written <br />agreement in effect prior to any loss or damage. <br />The person or organization indicated above is included as an additional insured under the following <br />endorsement(s): <br />Additional Insured - Owners, Lessees Or Contractors - Completed <br />Operations <br />CG 20 37 12 19 <br />Location and Description of Completed Operations: <br />Jobsites as described in contracts. Codes per the General Liability Declaration Page. <br />Any person or organization you are required to add as an <br />additional insured under a written contract or written <br />agreement in effect prior to any loss or damage. <br />The person or organization indicated above is included as an additional insured under the following <br />endorsement(s): <br />Additional Insured - Owners, Lessees Or Contractors - Scheduled Person <br />Or Organization <br />CG 20 10 12 19 <br />Location of Covered Operations: <br />Jobsites as described in contracts. <br />Job Description: <br />Codes per the General Liability Declaration Page. <br />Jobsites as described in contracts. Codes per the General Liability Declaration Page. <br />CG 89 05 10 14 Page 1 of 2 <br />04/02/2024A0080216 <br />Middlesex Insurance Company <br />00001 0000000000 24093 0 N1 bb1d3496-26f7-460f-b77f-b0dec72adacdbb1d3496-26f7-460f-b77f-b0dec72adacd <br />Docusign Envelope ID: CF064D56-F89A-8651-8229-D168AFF8B909