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For attachment to Policy No, Gla 50-W_�L , to complete said policy. Designation of Contractor —,a. •e,ow, Mailing Address xr r....,ew, Location of Covered Operations ,a—,. ...u., Check here if the following provision is applicable ADDITIONAL DECLARATIONS The person or organization designated above as the Contractor has undertaken to pay the premium for this policy and shall be entitled to receive any return premiums, if any, which may become payable under the terms of this policy. SCHEDULE The insurance afforded is only with respect to such of the following Coverages as are indicated by specific premium charge or charges The limit of the company's liability against eKh such Coverage shall be as stated hcretn subject to all the terms of this policy having reference thereto. ------ ---- 315 —16 2 92 Coverages limits of liability ►f"Wo mtems Rater Apanea Premiums $ 100 of cost A-BfMdy Injury Liability each occurrence - Q�Q00. ��J' 100 000. 5.049 49. 11 -Property Damage liability 000, eachoccurrence!% aggregaN s QQ QQQ• S. 0 j 53. NP Farm mrmbers of oneersements attacked at isle __ _ _-- $ teal Atbann Fiallf= S 102. When used as a premium bass -- -- - ---- ---- ---- _ -- --, "Cost" means the total cost to the named Mitered with respect to operations per!ormed f ' a named inswed during the policy period by mdependeM contraclors of all work let or sul let incoiwiection with each specific project, ncluding of all labor materials and equipment furnished, used or delivered for use in the execution of such work, whether furnished by the owner. controe..' subcontractor, including all fees. allowances bonuses or commissions made, paid or due COVERAGE "OOIIy HIMY LIABILITY Id► to any obligation for which the imIf or any ranter at his illtwer may be CO!lERABE :--PRNf�ir �AMACE LIAAIIITIr held liable under any workmen's compensation, unemployment compensation or disability benefits law or under any similar law. The comporly will pay on behalf of the Insured all sums which the ieered shall become legally otligated to pay as damages because of A. bodily Injury or B pritporty damage to which this policy applies caused by an Keorrence and arising out of I opera tiont performed for the Round insured by the contractor designated in the de, larollons at the local" "grated therein or (2, acts or omissions of the named measured in connection with his general supervision of such operations, and the company shall have the right and duty to defend any suit against the insetted seeking damages on account of such bodily Injury or property domaga, even if any of the alleptrons of the wit are groundless, false or fraudulent, and may make such investigation and settlement of any claim or wit as it deems expedient but the cornpoM shall not be obligated to pay any claim or udgment or to defend any wit after the applicable limit of the company s habilIly has been exhausted by payment of judgments or settlements Eaclmuem lhis policy does not apply 'a. io liab I t assumed by the Insured under any contrail or agreement except an iner/ewbl C*MrWt: but this exclusion does nor apply to a warranty that work performed by the designated contractor will be done in a workmarNtke manner th to bodily injury at property damage occurring after all work on the project tother than wiw,ce maintenance or repairs to tw performed by or on behalf of the named Insured at the site of the covered operations has been completed or that portion of the designated contractor s work out of which the injure or damage ernes has been put to its intended use by any person or organiza tion other than another contractor or subcontiacloi engaged in performing operations for a principal as a part of the same project c to be" or property damage arising out of any act or omission of the Round m or any of his employees, other thin general supervision of work performed fa the Mined leered by the designated contractor, lei to bodily injury !r, ary employee of the insured arising out of and in the course of firs employment by the insured or to any obligation of the insured to indemnity another because of damages arising out of such injury. but this exclusion does not apply to liability assumed by the insured under an incihntal contract. eft to property damage to i U property owned or occuptel by or rented to the unwed, (2) property used by the rowed. (3 Property in the care custody or contra: of the rowed or as to which the mewed is for any purpose exercising physical control, or a: work performed for the mitered by the designated contractor g to bodily injury or preperfy dMMI due to war, whether or not declared, civil war, insurrection, rebellion of revolution or to any act or condition, incident to any of the foregoing, with respect to ll) liability assumed by the insured under an incidental contract, tN (2) expenses for first aid under the Supplementary Payments provision of the policy h! to bodily injury or prrrtpyrty damage arising out cf 1 the ownership, mainte nonce opeiatien use loading Or unloading of any mobile eeaipment white being used in any prearranged or organized racing, speed or demolition contest or to any stunting wtivrty or in practice or preparation to any such contest or activity or (2i the operation or use of any snOwmob Fie or trailer designed for use therewith (ir to bodily nmjtmry or property daunt arising out of the discharge dispersal. release or escape of smoke, vapors. soot. fumes acids. alkalis. toxic chemr cats, liquids or gases. waste materials or other irritants contaminants or pollutants into or upon lard. the atmosphere or any water course of body of water. but this exclusion does not apply if such discharge dispersal release or escape is sudden and accidental ij to loss of use of tangible property wnwh has not been physically, injured or destroyed res-ting from (I' a delay in or lack of performance by or on behalf of the named insfrol of any roritract or agreement, or (2) the failure of the mauve/ ln~t prodwh e, wort performed by or c^ lowr)