AARP_Foundation_-_Endorsement_3.pdf

FAIC-SKLBUS-COCHG (6/01)

Policy Number

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

COMMON POLICY CHANGE ENDORSEMENT

Endorsement No.

Named Insured Effective Date:

12:01 A.M., Standard Time

Agent Name Agent No.

This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or conditions of coverage unless at the sole request of the insured.

COVERAGE PART INFORMATION ---- Coverage parts affected by this change as indicated by x below.

Commercial Property

Commercial General Liability

Commercial Crime

Commercial Inland Marine

The following item(s):

Insured’s Name Insured’s Mailing Address

Policy Number Company

Effective/Expiration Date Insured’s Legal Status/Business of Insured

Payment Plan Premium Determination

Additional Interested Parties Coverage Forms and Endorsements

Limits/Exposures Deductibles

Covered Property/Location Description Classification /Class Codes

Rates Underlying Exposure/ Insurance is (are) changed to read {See Additional Page(s) }

The above amendments result in a change in the premium as follows:

This premium does not include taxes and surcharges.

No Changes To be Adjusted at Audit Additional Return

Tax and Surcharge Changes

Additional Return

Countersigned By:

AUTHORIZED AGENT

11GPP4936916

07-01-23

14055 LOCKTON COMPANIES, LLC (NORTHEAST SERIES)

AARP

ARCH INSURANCE COMPANY

X NO CHARGE

X NO CHARGE NO CHARGE

THE FOLLOWING FORM(S) HAS BEEN AMENDED

CG 20 26 12-19 ADDL INSD - DESIGNATED PERSON OR ORG

ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME

Page 1 of 1 © Insurance Services Office, Inc., 2018 CG 20 26 12 19

POLICY NUMBER: 11GPP4936916 COMMERCIAL GENERAL LIABILITY

CG 20 26 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

ADDITIONAL INSURED – DESIGNATED

PERSON OR ORGANIZATION

COMMERCIAL GENERAL LIABILITY COVERAGE PART

SCHEDULE

Name Of Additional Insured Person(s) Or Organization(s):

STATE OF ARIZONA, AND ITS DEPARTMENTS, AGENCIES, BOARDS, COMMISSIONS,

UNIVERSITIES, OFFICERS, OFFICIALS, AGENTS, AND EMPLOYEES AS ADDITIONAL

INSUREDS WITH RESPECT TO LIABILITY ARISING OUT OF THE ACTIVITIES

PERFORMED BY OR ON BEHALF OF THE CONTRACTOR.

P.O. BOX 6123

PHOENIX, AZ 85005

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:

1. In the performance of your ongoing operations;

or

2. In connection with your premises owned by or rented to you.

However:

1. The insurance afforded to such additional insured only applies to the extent permitted by law; and

2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.

B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:

If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:

1. Required by the contract or agreement; or

2. Available under the applicable limits of insurance;

whichever is less.

This endorsement shall not increase the applicable limits of insurance.

This endorsement modifies insurance provided under the following: