Primary Non Contributory Wording Form – Fill Out and Use This PDF

POLICY NUMBER:	COMMERCIAL GENERAL LIABILITY
	UCIC 34 101 08 09

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

BLANKET ADDITIONAL INSURED- PRIMARY AND NON-CONTRIBUTORY-OWNERS, LESSEES OR CONTRACTORS

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name of Person or Organization:

In consideration of the additional premium of $250.00, it is hereby understood and agreed that

Section II — In accordance with the terms, conditions, limitations, and provisions of the policy to which this endorsement is attached, Section II- Who is an Insured is amended to include as an Additional Insured the person, organization or entity designated in this endorsement but only with respect to liability for bodily injury or property damage caused, in whole or in part, by your work at the designated construction project performed for the designated person, organization or entity and included in the ongoing operations hazard. This endorsement does not create on our part a duty to defend the designated person, organization or entity or to contribute to or reimburse the designated person, organization or entity for any fees or expenses incurred by an insured in the defense of the designated person, organization or entity. This endorsement is only applicable if the designated person, organization or entity and the designated project sections are completed.

With respect to the Insurance afforded to these Additional Insureds, the following additional exclu- sions apply:

This Insurance does not apply to "bodily injury" or "property damage" occurring after:

1.All work, including materials, parts or equipment furnished In connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the Additional Insured(s) at the location of the covered operations has been completed; or

2.That portion of "your work" out of which the injury or damage arises has been put to its in- tended use by any person or organization other than another contractor or subcontractor en- gaged in performing operations for a principal as a part of the same project.

PRIMARY/ NON-CONTRIBUTORY WORDING:

It is agreed that this insurance is primary and non-contributory and that no insurance held or owned by the designated Additional Insured shall be called upon to cover a loss under said policy up to the limits of this policy if loss under this policy arises directly from work performed by Named Insured or if others performed on behalf of the Named Insured.

All other terms, conditions and exclusions remain unchanged

UCIC 34 101 08 09	© United Contractors Ins. Co. RRG
	All rights reserved
Form Edition 05/10/11	Page 1 of 1