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POLICY NUMBER: GLO34953OS-O1 COMMERCIAL GENERAL LIAf3i Lill' <br />NAMED INSURED: AMERICAN CIVIL CONSTRUCTORS, INC. <br />RANDALL $ BLAKE, INC. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASfi READ IT CAREFULLY. <br />ADDITIONAL INSURED -OWNERS, LESSEES OR <br />CONTRACTORS (Form B) <br />This endorsement modifies insurance provided under the following: <br />cor>nrnERCIAL GENERAL LIABiuTY COVERAGE PART. <br />Name of Person or Organization: <br />As Required by Written Contract <br />__ __ _ SCHEDULE <br />Re: Atl operations. <br />(If no entry appears above, information required to complete this endorsement will be shown n the <br />Declarations as applicable to this endorsement.) <br />WHO IS~AN INSURED (Section 111 is amended to include as an insured the person or organization <br />shown m the Schedule, but cnly rvith respect to liability arising out of "your work" for that insured by or <br />for you. <br />Primary Insurance: <br />It is further agreed that such insurance as is afforded by this policy for the benefit of the above <br />Additional Insureds) shall be primary insurance as respects any claim, IOSS or liability arising out <br />of the Named Insured's operations, antl any other insurance maintained by the Additional <br />Irsured(s) shall be excess and non-contributory with the insurance provided hereunder. <br />GG 20 10 t 1 a;5 Copyright. Insurance Services Office, Inc.. 198a <br /> <br />