PERMFILE50884

• Permit No: C1982056
• IBM Index Class Name: Permit File
• Doc Date: 12/11/2001
• Section_Exhibit Name: Tipple EXHIBIT 2 CERTIFICATE OF INSURANCE
• Media Type: D
• Archive: No

j
•
VENDORS-BROAD FORM-ADDITIONAL INSURED FORM
This form modifies such insurance as is afforded by the provisions
of the policy relating to the following:
COMPREHENSIVE GENERAL LIABILITY INSURANCE
COMPLETED OPERATIONS AND PRODUCTS LIABILITY INSURANCE
It is agreed that the "Persons Insured" provision is amended to
include any person or organization designated below (herein referred
to as "vendor"), as an insured, but only with respect to the distri-
bution or sale in the regular course of the vendor's business of the
named insured's products subject to the following additional provisions:
1. The insurance with respect to the vendor does no[ apply to:
a. any express warranty unauthorized by the named insured;
b. bodily injury or property damage arising out of
i. any physical or chemical change in the form of the product
made intentionally by the vendor.
ii. repacking, unless unpacked solely for the purpose of inspection,
demonstration, testing or the substitution of parts under
instruction from the manufacturer and then repacked in the
original container,
. iii. demonstration, installation, servicing or repair operations,
except such operations performed at the vendor's premises in
connection with the sale of the product, or
iv. products which after distribution or sale by the named insured
have been labeled or relabeled or used as a container, part or
ingredient of any other thing or substance by or for the vendor.
2. The insurance does not apply to any person or organization, as insured,
from whom the named insured has acquired such products or any ingred-
ient, part of container entering into, accompanying or containing such
products.
NAME OF PERSON OR ORGANIZATION
\'