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Certificates of InsuranceCERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 10/26/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: 144565831 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, .,,.. „.. TYPE OF INSURANCE ® ......,.. INSD POLICY NUMBER ........... MM DD YYY?' 6C'Y EXP" ....... .......m.�.� . ,.... -. _ LTR DYYYY LIMITS COMMERCIAL GENERAL CLAIMS -MADE LIABILITY Y Y GL20929410401 11/2/2018 11/2/2019 EACH OCCURRENCE $ 1 000 000 ., .I ,.. m .. _.- X OCCUR PRISES„(Ea occurrelce,) ... $ 100 000 AP� 7p,�Md4IASK �..N P a -GPENERAL (LAGGREGATE -,000 � PPI,ERSONA&ADVINJURY $1000,000 GEN'L AGGREGATE LIMIT ALES PER: POLICY X, ECO$2,000,000 JLOC „ PIOPAGG $2.000QyQlp OTHER: $ A AUTOMOBILE LIABILITY Y Y - CA20929390401 11/2/2018 11/2/2019 O6105INED SINME LpMI $ _._ ,(Eo o=,dgrr� .... 1 9990,99. X ANY AUTO BODILY INJURY (Per person) $ _._ LY INJURY (Per accident) ALL OWNED SCHEDULED BODIer accen AUTOS � ,.. AUTOS ( ) $ NON -OWNED IPIRP,JPER T_ Y DAMAGE $ HIRED AUTOS AUTOS A'Iper acadeglt. ---- ,w.. B X UMBRELLA LIAB X OCCUR Y Y CU21929420402 11/2/2018 11/2/2019 EACH OCCURRENCE $ 4,000,000 .... eee ,.....m EXCESS LIAR CLAIMS MADE E $ 4,000,000 QED RETENTION$ $ A AND EMPLOYERS WORKERS N A TIOI N YIN Y WC209452604 11/2/2018 11/2/2019 X STATUTE _ERry ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/AL EACH ... ,, 00000 (Mandatory In NH) E L DISEASE EA EMPLOYEE: $ 5 ACH ACCIDENT $ 5 If yes, describe under 00 000 DESCRIPTION OF OPERATIONS below E1, DISEASE - POLICY LIMIT $ 500„000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The following policy provisions 'and)br Endorsements form part of the policies of insurance represented by this certificate of insurance. The terms contained in the policies and/or endorsements supersede the representations made herein. Electronic copies of the policy provisions and/or endorsements listed below are available by emalling: certificates@ba'rlbinc.corn When required by written contract, those parties listed in said contract, including the Certificate Holder, are added as additional insureds with respect to the General Liability including ongoing and completed operations, Auto Liability, and Umbrella Liability as afforded by the policy and/or endorsements. When required by written contract, waiver of Subrogation is granted with respect to the General Liability, Auto Liability, Workers Compensation, and Umbrella See Attached... CERTIFICATE MOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-213 AUTHORIZED REPRESENTATIVE Key West FL 33040 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PEDROFALCO LOC #: ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Bowen, Miclette & Britt of Florida, LLC Pedro Falcon Electrical Contractors, Inc. -....w 31160 Avenue C POLICY NUMBER I Big Pine Key FL 33043-4516 CARRIER I NAIC CODE EFFECTIVE DATE: Page 1 of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ rT CAREFULLY, CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT - FORM A Thm endorsement modifies insurance provided Lnder the following, COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number GL20929410401 Policy Expiration 04tv lllWO19 Named Insured PEDRO FALCON ELECTRICAL MnRACTORS INC Agency Number O�45507 Date Agency BOWEN MICLE--TE & BRITT OF FLQR--DA, LLC Policy Eftcvve Date 11 r2= 18 Account Number 11228245 Issuing Company AMBRISURE INSURANCE ::OM PAM' 1, a. SECTIONR -WHO IS AN INSURED is amended to add as an additional insured any person or organization- (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business; or l2) Who is named as an additional insured under this policy on a certificate of insurance b. The written contract, written agreement, or certificate of insurance must: (1) Require addifional insured status for a tir-ne period during the term of this policy; and (2) Be executed prior to the "bodi.y injury`. "property damage". or "personal and advertising injury" leading to a claim under this policy, c. if. however t11) "Your work" began under a letter ointent or work order-, and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work: and (3) Your customer's customary contracts require persons or organizations to be named as additional insureds-, wewill provide additional insured status as specified in this endorsement, 2. The insurance provided under this endorse rnent is limited as follows; a. That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a) Own; (b) Rent, (c) Lease: or (d) Occupy: (2) Ongoing operations perio rme d -by you or on your behalf. Ongoiog operations does not a ppl y to "bodily injun y"or "property damage" occurring after: lnckidic5 copyrighted material of Insurance Services Office, IrIL. CG 70 40 1915 pages 1 of 4 POLICY fiGIL209294110401 EFFECTIVE DATES: 11 r212018.1 I rMO 19 (a) A3 work to be performed by you or on your behaff for tf,,e additional insrArerYS) at the site of the Covered optratjw,is is COMPICIC, irlClUdirng related materials, parts or it folher than service, maintenance or repairs),, cir (b) That. oortio,n of "your work- nin of yol-iich the injury or, darnage arises is piut to its intended use by any Person or organization other ftn another contractor workinp for a principal as a pan of Ilse same project, (3) Compl M-ed operations coverage, but orily if: (a) The written contract, written agreement, or certificate of inUiraice requires completed Operations coverage of "ytxir work" coveiragt; and M Thiscoveraipe parl provi(le�,Lgverage for "bodily irjury'or 'property darnage' included withn tl''' "PludUCts-CUMPIOTed operations hazard". However, the insurance afforded to such pddilional insured only applies to the eXtent PtIfflilted by law. b, If the wntten contract. written agfeel-le0t. or certificate of insurance- fl} Reciurres "arKing nurt ot'llanguage; Or (2) Requires you to provide additional insured coverage to that person, or organ '2aticin by the uip. nt either or both of the following, (a) Add iaD nall Ins urpci - Owners, LAe ssees or Contractors -Scheduled Person Or Cregain ization P_nd0r1,ement CG 2t;) 1010 01, or (b) Additional Insured - Owners. Lessees or Contractors - Completpri Operations endorsernent CG 20 37 10 01; then the phrase "CaUsed, in whole or in part, by' in paragraph 2,4. a we is replaced by 'arising out of", c� If the written contract, writlem a(,�I reenicrit, or choicafe- , of insurance tecluires you to provide additional inGured coverace, to that PV50111 Q Olydniza6011 by the Use 014, (1) Additfortal Insured - Owners, Lessees or Contractors - SchedUled Person Of Orcianization endorsement CG 20 10 07 04 or CG 20 10 04 13, uau (2) Additional Insured- Owners, Lessees or Ccx7tractilr5 - Completed operations endorsement CO 20 37 07 01 or CO 20 37 04 13-1 or (3) Both those endorsements with either of Chose edition dates; or (4) Either or both of the fojlovqng: la) Addritional lf',sured - Owners, L,-­,ePs or COTItraclors, - Scmeduled Person, Or Organization endorFempnt CG 20 10 without an edition date tpecjfje(l; of (b) AcIctitional Insured -- Owners, Lessees or Contractors - Cotripleted Operations endomornent CG, 20 37 without an edition date specified, then paragraph 2.a, above applies, dl, Premises, as respects paragraph 2.a,(I) abovc, include-, common or public- areas about 511(h Premises if so required in the Yvritten Contfact or vaitten agreemerpt. c Additional insured, status provded U11der paragrap?is 2,a,(J)(b) 4:w Zai.(I.Ac) above does not extend beYoild the end of a premises least or rental agreement, E The limits of insurance that appiy to tie ad6fional insured are the least Of 1lhG5e specified in the: (1) W(ittell contract; (2) Written agreement. Di Certificate of insurance, or (4) Declaration& of mlis poficy, 'The limits of insurance are inclusive of and net in addition to the limits of Jn,5urance shown in the Declarations, InCIU&S copyrighted material of lrjsurance -services lfie-e, hr Page 2 of 4 CG 70 48 10 1s POLICY #GL20929410401 EFFECTIVE DATES, I I f2rA 18-1112J2019 g. The insur&xe provided to the ddditkmal insured do c-s no apply to Udily lnjurj", "property damage", or "porsenal and adveilis[rig jnjtjr�y" arlsIng out i)f In 1r(,hiteCt'5, enginner's, or gurveyor's, rendering of, or ta4ure to render, any professtonal services, including but not 'United W (a) maps; (b) Drawings: (C) opinioos: (d) Reports; (e) Surveys; (f) Change orders; (g) Design Specifications, and (2) Supervisory,, rnspccticin, or erigmeenng services, h. SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4, other Insurance 6�leted and rep8oad with thoe following: I 7 flTy A 'fin VL111u cillu I-ulle( leaii-Y-111 available to the addition-il insured whether a. Primary; b. Excess, c. Cortirgent; or d. On any other basis: but if Vie written rontrao, written agreement. or certificare of jnSUrAr)C,-- "OrES pirimary ant] non- contribtjto� coveraji. J�is Iiiijil 00-0 we will not share with that other 4sura-tce, I. If the written contract, vydoten aqro-empnt, or reirtificate. of insurance as ciatfined above requires, additional insured status by use of (�Q 20 1() 11 85, then the coverage provided under this CG 70 48 endorsement does not apply except for paragraph 2.h. Other Insurance. Additional insured 10W�, is limited to that provided by CG 20 10 11 85 shown be.fow and par�jqraph 2A Other insurance shown above. . .. . ....... ...... CONTRACTORS (FORM B) This endorsement rTic,difies insurance provided under the follciviioq: COMMERCIAL GENERAL LIA81UTY COVERAGE PART, Name of Person or Organization; Blanket Where Reqvired by Written Contract, Agreement, or Certificate of Insuiairice that the terms of CG 20 10 11 85 apply (if no entryappears above, information required to complete this endorsement will be shown in the occlairations as applicable to this endorsement.) VftiQ IS AN I W5666 6616"1 W 6 wliwiw ii, ic"'i w, www" %UlIIlgllliIlil im CG 20 10 11 85 Copyright, Instir-am7e, Services office. Inc , 19P.4 ......... .. . . --'— . ........ Includes copyrighted material of Insurance Services Office, Inc, CG 70 4810 15 Pages 3 of 4 The Provided by, Ihis endofsement does nail aPPlY to ally rjreu6swpm work, for Mrich thi-A pep -son or organizatiorm is �pccffirMly fistc(l as of ad(jition,0 insured an anolher enclorsement atticjjejr:I to INS pohcy, 111rx-11.11de's F "Opyrighied matericW. of Msq,lrancip�. Svvjjc.er" Office, Inc, Flage 4 of 4 CG 70 48 10 13 AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 110/26/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Bowen, Miclette & Britt of Florida, LLC 1020 N. Orlando Avenue, Suite 200 Maitland FL 32751 CONTANAME: Pam Medley PHONE 407 647-1616 FAX 407 628-1635 A C No E-MAIL , certificates bmbinc.com �° INSURERS AFFORDING COVERAGE NAIC # INSURERA:Amerisure Insurance Company 19488 INSURED PEDROFALCO INSURERB:Amerisure Mutual Insurance Company 23396 Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C INSURER C : Big Pine Key FL 33043-4516 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 14208128 REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y Y GL2092941 11/2/2017 11/2/2018 EACH OCCURRENCE $1,000,000 CLAIMS -MADE X❑ OCCUR DAMAGE TO RENTED PREMISES Eaoccurrence $100,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY ECT LOG PRODUCTS - COMP/OPAGG $2,000,000 $ OTHER: A AUTOMOBILE LIABILITY Y Y CA2092939 11/2/2017 11/2/2018 COMBINED MIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO ALL OWNED SCHEDULED HIRED AUTOS NON -OWNED EPROPERTY AUTOS BODILY INJURY (Per accident) $ DAMAGE Per accident $ B X UMBRELLA LIAB X OCCUR Y Y CU2092942 11/2/2017 11/2/2018 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 EXCESS LIAB CLAIMS -MADE DED F I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE FNI OFFICER/MEMBER EXCLUDED? N / A y WC2094526 11/2/2017 11/2/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $500,000 E.L. DISEASE - EA EMPLOYEE $500,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The following policy provisions and/or endorsements form part of the policies of insurance represented by this certificate of insurance. The terms contained in the policies and/or endorsements supersede the representations made herein. Elec nic copies the policy provisions and/or endorsements listed below are available by emailing: certificates@bmbinc.com G WENT,/ �{� BYWFV See Attached... WA ULKI II-H;A I t MULULK UANI;tLLA I IUN Monroe County Board of County Commissioners 1100 Simonton Street Suite 2-213 Key West FL 33040 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: PEDROFALCO ACO LOC #: ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Bowen, Miclette & Britt of Florida, LLC NAMEDINSURED Pedro Falcon Electrical Contractors, Inc. 31160 Avenue C Big Pine Key FL 33043-4516 ' POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE When required by written contract, those parties listed in said contract, including the Certificate Holder, are added as additional insureds with respect to the General Liability including ongoing and completed operations, Auto Liability, and Umbrella Liability as afforded by the policy and/or endorsements. When required by written contract, waiver of Subrogation is granted with respect to the General Liability, Auto Liability, Workers Compensation, and Umbrella Liability to those parties listed in said contract, including the Certificate Holder. The General Liability and Umbrella Liability certified herein are primary and non-contributory to other insurance available, but only to the extent required by written contract. Project: Demo Old/Install New Transfer Station Offices ACORD 101 (2008101) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 4 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CONTRACTOR'S BLANKET ADDITIONAL INSURED ENDORSEMENT - FORM A This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART Policy Number GL 2092941 Agency Number 0845507 Policy Effective Date 11/02/2017 Policy Expiration Date Date Account Number 11/02/2018 11228245 Named Insured Agency Issuing Company PEDRO FALCON ELECTRICAL BOWEN MICLETTE & BRITT OF AMERISURE INSURANCE CONTRACTORS INC FLORIDA, LLC COMPANY 1. a. SECTION Il - WHO IS AN INSURED is amended to add as an additional insured any person or organization: (1) Whom you are required to add as an additional insured on this policy under a written contract or written agreement relating to your business; or (2) Who is named as an additional insured under this policy on a certificate of insurance. b. The written contract, written agreement, or certificate of insurance must: (1) Require additional insured status for a time period during the term of this policy; and (2) Be executed prior to the "bodily injury', 'property damage', or "personal and advertising injury' leading to a claim under this policy. c. If, however: (1) "Your work" began under a letter of intent or work order; and (2) The letter of intent or work order led to a written contract or written agreement within 30 days of beginning such work; and (3) Your customers customary contracts require persons or organizations to be named as additional insureds; we will provide additional insured status as specified in this endorsement. 2. The insurance provided under this endorsement is limited as follows: a. That person or organization is an additional insured only with respect to liability caused, in whole or in part, by: (1) Premises you: (a) Own; (b) Rent; (c) Lease, or (d) Occupy; (2) Ongoing operations performed by you or on your behalf. Ongoing operations does not apply to "bodily injury" or "property damage" occurring after: Includes copyrighted material of Insurance Services Office, Inc. CG 70 48 10 15 Pages 1 of 4 (a) All work to be performed by you or on your behalf for the additional insured(s) at the site of the covered operations is complete, including related materials, parts or equipment (other than service, maintenance or repairs); or (b) That portion of "your work" out of which the injury or damage arises is put to its intended use by any person or organization other than another contractor working for a principal as a part of the same project. (3) Completed operations coverage, but only if: (a) The written contract, written agreement, or certificate of insurance requires completed operations coverage or "your work" coverage; and (b) This coverage part provides coverage for "bodily injury" or "property damage" included within the "products -completed operations hazard". However, the insurance afforded to such additional insured only applies to the extent permitted by law. b. If the written contract, written agreement, or certificate of insurance: (1) Requires "arising out of language; or (2) Requires you to provide additional insured coverage to that person or organization by the use of either or both of the following: (a) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 10 01; or (b) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 10 01; then the phrase "caused, in whole or in part, by" in paragraph 2.a. above is replaced by "arising out of'. c. If the written contract, written agreement, or certificate of insurance requires you to provide additional insured coverage to that person or organization by the use of: (1) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 07 04 or CG 20 10 04 13; or (2) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 07 04 or CG 20 37 04 13; or (3) Both those endorsements with either of those edition dates; or (4) Either or both of the following: (a) Additional Insured — Owners, Lessees or Contractors — Scheduled Person Or Organization endorsement CG 20 10 without an edition date specified; or (b) Additional Insured — Owners, Lessees or Contractors — Completed Operations endorsement CG 20 37 without an edition date specified; then paragraph 2.a. above applies. d. Premises, as respects paragraph 2.a.(1) above, include common or public areas about such premises if so required in the written contract or written agreement. e. Additional insured status provided under paragraphs 2.a.(1)(b) or 2.a.(1)(c) above does not extend beyond the end of a premises lease or rental agreement. f. The limits of insurance that apply to the additional insured are the least of those specified in the: (1) Written contract; (2) Written agreement: (3) Certificate of insurance; or (4) Declarations of this policy. The limits of insurance are inclusive of and not in addition to the limits of insurance shown in the Declarations. Includes copyrighted material of Insurance Services Office, Inc. Page 2 of 4 CG 70 48 10 15 g. The insurance provided to the additional insured does not apply to "bodily injury", "property damage", or "personal and advertising injury" arising out of an architect's, engineer's, or surveyor's rendering of, or failure to render, any professional services, including but not limited to: (1) The preparing, approving, or failing to prepare or approve: (a) Maps; (b) Drawings; (c) Opinions; (d) Reports; (e) Surveys; (f) Change orders: (g) Design specifications; and (2) Supervisory, inspection, or engineering services. h. SECTION IV— COMMERCIAL GENERAL LIABILITY CONDITIONS, paragraph 4. Other Insurance is deleted and replaced with the following: 4. Other Insurance. Coverage provided by this endorsement is excess over any other valid and collectible insurance available to the additional insured whether: a. Primary; b. Excess; c. Contingent: or d. On any other basis: but if the written contract, written agreement, or certificate of insurance requires primary and non- contributory coverage, this insurance will be primary and non-contributory relative to other insurance available to the additional insured which covers that person or organization as a Named Insured, and we will not share with that other insurance. i. If the written contract, written agreement, or certificate of insurance as outlined above requires additional insured status by use of CG 20 10 11 85, then the coverage provided under this CG 70 48 endorsement does not apply except for paragraph 2.h. Other Insurance. Additional insured status is limited to that provided by CG 20 10 11 85 shown below and paragraph 2.h. Other Insurance shown above. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. SCHEDULE Name of Person or Organization: Blanket Where Required by Written Contract, Agreement, or Certificate of Insurance that the terms of CG 20 10 11 85 apply (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) WHO IS AN INSURED (Section II) is amended to include as an insured the person or organization shown in the Schedule, but only with respect to liability arising out of "your work" for that insured by or for you. I CG 20 10 1185 Copyright, Insurance Services Office, Inc., 1984 Includes copyrighted material of Insurance Services Office, Inc. CG70481015 Pages 3 of 4 4 S j. The insurance provided by this endorsement does not apply to any premises or work for which the person or organization is specifically listed as an additional insured on another endorsement attached to this policy. Includes copyrighted material of Insurance Services Office, Inc. Page 4 of 4 CG 70 4810 15