Agenda Item
b. Big Brothers Big Sisters of Metro Atlanta Level Up: In-school Mentoring Services (Not to Exceed $249,995)
Summary: Presented by: Triscilla Weaver, Ph.D., Chief of Access and Opportunity, Division of Access and Opportunity
Request: It is requested that the DeKalb County Board of Education approve the Memorandum of Understanding between Big Brothers Big Sisters of Metro Atlanta and the DeKalb County School District (DCSD) to provide Level Up: In-School Mentoring services to 400 students at Lithonia Middle School during the 2026-2027 school year.
Why: Lithonia Middle School has worked in partnership with the Big Brothers Big Sisters of Metro Atlanta program for the past three years, and the results show an improvement in attendance and behavior for participating students. The DCSD would like to continue to implement the Level Up: In-School Mentoring program at Lithonia Middle School to support students in developing a vision for the future, avoid risky behavior(s), and assist in their development of having a sense of belonging. Lithonia Middle School was selected based on at-risk concerns presented by students.
Details: The Level Up program utilizes nine paid staff members, including one mentoring supervisor, and eight lead mentors, who facilitate mentorship within the school day for students in a 1:5 adult mentor to student mentee ratio and in 1:1 settings for select students. The program has the capacity to serve up to 400 students.
Financial impact: Purchased Professional and Technical Services 462.1000.530000.03221.7020.1779. 8010.090.0000 (Title IV grant)
Contact: Triscilla Weaver, Ph.D., Chief of Access and Opportunity, Division of Access & Opportunity, 678-676-0485
Latashia W. Searcy, EdD., Executive Director of Student Mentorship and Partnerships, Division of Access & Opportunity Division, 404-808-8874
Effective: August 3, 2026 - July 30, 2027
Status: Approved by the Office of Legal Affairs
DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 01/06/2026
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 have ADDITIONAL INSURED provisions or 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).
PRODUCER CONTACT Eric Whitt
NAME:
Hilb Group Southeast PHONE FAX
(A/C, No, Ext): (A/C, No):
PO Box 21154 E-MAIL ewhitt@hilbgroup.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE NAIC #
Columbia SC 29221 INSURER A : Alliance of Nonprofits for Insurance, Risk Retention 10023
Group, Inc
INSURED INSURER B : National Liab & Fire Insurance Co 20052
Big Brothers Big Sisters of Metro Atlanta, Inc. INSURER C : Travelers Property Casualty Insurance Co 36161
680 Murphy Ave SW INSURER D :
Suite 1090 INSURER E :
Atlanta GA 30310 INSURER F :
COVERAGES CERTIFICATE NUMBER: 1/1/26-27 MASTER 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 ADDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED 500,000
CLAIMS-MADE OCCUR PREMISES (Ea occurrence) $
Professional Liability MED EXP (Any one person) $ 20,000
A Abuse Y 02-CP-0031443-01-14 01/01/2026 01/01/2027 PERSONAL & ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
PRO- 3,000,000
POLICY JECT LOC PRODUCTS - COMP/OP AGG $
OTHER: Prof. Liab./Abuse $ 1,000,000
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
(Ea accident)
ANY AUTO BODILY INJURY (Per person) $
A OWNED SCHEDULED 02-CA-000000309-14 01/01/2026 01/01/2027 BODILY INJURY (Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per accident)
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3,000,000
A EXCESS LIAB CLAIMS-MADE 02-UB-0031443-01-14 01/01/2026 01/01/2027 AGGREGATE $ 3,000,000
DED RETENTION $ ISC & SSP $ $1M/$1M
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000
B OFFICER/MEMBER EXCLUDED? N/A WC-2026-81530-00 01/01/2026 01/01/2027
(Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
Cyber Agg Limit 2,000,000
Cyber Liability/Crime
C Directors & Officers Liability 106457456/107415633 01/01/2026 01/01/2027 Employee Theft 1,000,000
Directors & Officers 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Stream Realty Partners-Atlanta, L.P. and Sunrise Properties LLC are included as additional insureds for GENERAL LIABILITY per form CG 20260704 as
required by written contract or agreement.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Sunrise Properties LLC c/o Stream Realty Partners-Atlanta, LP ACCORDANCE WITH THE POLICY PROVISIONS.
1115 Howell Mill Road
AUTHORIZED REPRESENTATIVE
Suite 300
Atlanta GA 30318
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 01503644
LOC #:
ADDITIONAL REMARKS SCHEDULE Page of
AGENCY NAMED INSURED
Hilb Group Southeast Big Brothers Big Sisters of Metro Atlanta, Inc.
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: Notes
The aforementioned entities are included as additional insureds for GENERAL LIABILITY per form CG 20260704 as required by written contract or
agreement.
**INFORMATION PROVIDED ON A CERTIFICATE OF INSURANCE IS REGULATED BY THE GEORGIA DEPARTMENT OF INSURANCE. FOR
INFORMATION REGARDING FURTHER REQUESTS FOR CHANGES TO THIS CERTIFICATE OF INSURANCE, PLEASE REFER TO THE
GEORGIA DEPARTMENT OF INSURANCE WEBSITE FOR GOVERNING RULES.
FAILURE TO COMPLY WITH REGULATIONS COULD RESULT IN FINES UP TO $5,000 PER
VIOLATION.
ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
POLICY NUMBER: 2024-31443
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED
PRIMARY AND NON-CONTRIBUTORY
ENDORSEMENT FOR PUBLIC ENTITIES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
A. Section II – WHO IS AN INSURED is amended to include:
4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers
of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a
written contract or written agreement presently in effect or becoming effective during the term of this policy,
that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an
additional insured(s) on your policy, but only with respect to liability for “bodily injury”, “property damage” or
“personal and advertising injury” caused, in whole or in part, by:
a. Your negligent acts or omissions; or
b. The negligent acts or omissions of those acting on your behalf;
in the performance of your ongoing operations.
No such public entity or individual is an additional insured for liability arising out of the sole negligence by
that public entity or its designated individuals. The additional insured status will not be afforded with
respect to liability arising out of or related to your activities as a real estate manager for that person or
organization.
B. Section III – LIMITS OF INSURANCE is amended to include:
8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional
insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and
that public entity, or the limits available under this policy, whichever are less. These limits are part of and
not in addition to the limits of insurance under this policy.
C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of
SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following:
4. Other Insurance
a. Primary Insurance
This insurance is primary if you have agreed in a written contract or written agreement:
(1) That this insurance be primary. If other insurance is also primary, we will share with all that
other insurance as described in c. below; or
ANI-RRG-E61 02 19 Page 1 of 2
POLICY NUMBER: 2024-31443
(2) The coverage afforded by this insurance is primary and non-contributory with the additional
insured(s)’ own insurance.
Paragraphs (1) and (2) do not apply to other insurance to which the additional insured(s) has been
added as an additional insured or to other insurance described in paragraph b. below.
b. Excess Insurance
This insurance is excess over:
1. Any of the other insurance, whether primary, excess, contingent or on any other basis:
(a) That is Fire, Extended Coverage, Builder’s Risk, Installation Risk or similar coverage for
"your work";
(b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily
occupied by you with permission of the owner;
(c) That is insurance purchased by you to cover your liability as a tenant for "property damage"
to premises temporarily occupied by you with permission of the owner; or
(d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent
not subject to Exclusion g. of SECTION I – COVERAGE A – BODILY INJURY AND
PROPERTY DAMAGE.
(e) Any other insurance available to an additional insured(s) under this Endorsement covering
liability for damages which are subject to this endorsement and for which the additional
insured(s) has been added as an additional insured by that other insurance.
(1) When this insurance is excess, we will have no duty under Coverages A or B to defend the
additional insured(s) against any "suit" if any other insurer has a duty to defend the additional
insured(s) against that "suit". If no other insurer defends, we will undertake to do so, but we will
be entitled to the additional insured(s)’ rights against all those other insurers.
(2) When this insurance is excess over other insurance, we will pay only our share of the amount of
the loss, if any, that exceeds the sum of:
(a) The total amount that all such other insurance would pay for the loss in the absence of this
insurance; and
(b) The total of all deductible and self-insured amounts under all that other insurance.
(3) We will share the remaining loss, if any, with any other insurance that is not described in this
Excess Insurance provision and was not bought specifically to apply in excess of the Limits of
Insurance shown in the Declarations of this Coverage Part.
c. Methods of Sharing
If all of the other insurance available to the additional insured(s) permits contribution by equal
shares, we will follow this method also. Under this approach each insurer contributes equal
amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever
comes first.
If any other the other insurance available to the additional insured(s) does not permit contribution by
equal shares, we will contribute by limits. Under this method, each insurer’s share is based on the
ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers.
ANI-RRG-E61 02 19 Page 2 of 2
POLICY NUMBER: 2024-31443 FORM: ANI-RRG-E25 12 15
NAMED INSURED: Big Brothers Big Sisters of Metro Atlanta, Inc.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - DESIGNATED PERSON
OR ORGANIZATION -
FOOD CONTRIBUTIONS OR CLIENT REFERRALS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name of Person or Organization:
Any person or organization that you are required to add as an additional insured on this policy, under a written
contract or agreement currently in effect, or becoming effective during the term of this policy, in consideration
of food contributions or client referrals you receive from them.
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 shown in the Declarations; whichever is less. This
endorsement shall not increase the applicable Limits of Insurance shown in the Declarations.
ANI-RRG-E25 12 15 Page 1 of 1
POLICY NUMBER: 2024-31443 COMMERCIAL GENERAL LIABILITY
Named Insured: Big Brothers Big Sisters of Metro Atlanta, Inc. CG 20 26 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
Any person or organization that you are required to add as an additional insured on this policy, under a written
contract or agreement currently in effect, or becoming effective during the term of this policy. The additional
insured status will not be afforded with respect to liability arising out of or related to your activities as a real
estate manager for that person or organization.
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 B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following is added to
organization(s) shown in the Schedule, but only Section III – Limits Of Insurance:
with respect to liability for "bodily injury", "property
damage" or "personal and advertising injury" If coverage provided to the additional insured is
caused, in whole or in part, by your acts or required by a contract or agreement, the most we
omissions or the acts or omissions of those acting will pay on behalf of the additional insured is the
on your behalf: amount of insurance:
1. In the performance of your ongoing operations; 1. Required by the contract or agreement; or
or 2. Available under the applicable Limits of
2. In connection with your premises owned by or Insurance shown in the Declarations;
rented to you. whichever is less.
However: This endorsement shall not increase the
1. The insurance afforded to such additional applicable Limits of Insurance shown in the
insured only applies to the extent permitted by Declarations.
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.
CG 20 26 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER: 2024-31443 COMMERCIAL GENERAL LIABILITY
Named Insured: Big Brothers Big Sisters of Metro Atlanta, Inc. CG 20 34 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - LESSOR OF LEASED
EQUIPMENT - AUTOMATIC STATUS WHEN
REQUIRED IN LEASE AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II – Who Is An Insured is amended to A person's or organization's status as an
include as an additional insured any person(s) or additional insured under this endorsement ends
organization(s) from whom you lease equipment when their contract or agreement with you for such
when you and such person(s) or organization(s) leased equipment ends.
have agreed in writing in a contract or agreement
that such person(s) or organization(s) be added as B. With respect to the insurance afforded to these
an additional insured on your policy. Such additional insureds, this insurance does not apply
person(s) or organization(s) is an insured only with to any "occurrence" which takes place after the
respect to liability for "bodily injury", "property equipment lease expires.
damage" or "personal and advertising injury"
caused, in whole or in part, by your maintenance,
C. With respect to the insurance afforded to these
operation or use of equipment leased to you by
additional insureds, the following is added to
such person(s) or organization(s).
Section III – Limits Of Insurance:
However, the insurance afforded to such additional
The most we will pay on behalf of the additional
insured:
insured is the amount of insurance:
1. Only applies to the extent permitted by law;
1. Required by the contract or agreement you
and
have entered into with the additional insured;
2. Will not be broader than that which you are
or
required by the contract or agreement to
2. Available under the applicable Limits of
provide for such additional insured.
Insurance shown in the Declarations;
whichever is less.
This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
CG 20 34 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER: 2024-31443 COMMERCIAL GENERAL LIABILITY
Named Insured: Big Brothers Big Sisters of Metro Atlanta, Inc. CG 20 11 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – MANAGERS OR
LESSORS OF PREMISES
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Designation Of Premises (Part Leased To You):
Name Of Person(s) Or Organization(s) (Additional Insured):
Any person or organization acting as a manager or lessor of a covered premises that you are required to
name as an additional insured on this policy, under a written contract, lease or agreement currently in effect,
or becoming effective during the term of this policy.
Additional Premium: Included
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 2. If coverage provided to the additional insured
include as an additional insured the person(s) or is required by a contract or agreement, the
organization(s) shown in the Schedule, but only insurance afforded to such additional insured
with respect to liability arising out of the will not be broader than that which you are
ownership, maintenance or use of that part of the required by the contract or agreement to
premises leased to you and shown in the provide for such additional insured.
Schedule and subject to the following additional
exclusions: B. With respect to the insurance afforded to these
additional insureds, the following is added to
This insurance does not apply to: Section III – Limits Of Insurance:
1. Any "occurrence" which takes place after you
cease to be a tenant in that premises. If coverage provided to the additional insured is
2. Structural alterations, new construction or required by a contract or agreement, the most we
demolition operations performed by or on will pay on behalf of the additional insured is the
behalf of the person(s) or organization(s) amount of insurance:
shown in the Schedule. 1. Required by the contract or agreement; or
2. Available under the applicable Limits of
However: Insurance shown in the Declarations;
1. The insurance afforded to such additional whichever is less.
insured only applies to the extent permitted
by law; and This endorsement shall not increase the
applicable Limits of Insurance shown in the
Declarations.
CG 20 11 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER: 2024-31443 COMMERCIAL GENERAL LIABILITY
Named Insured: Big Brothers Big Sisters of Metro Atlanta, Inc. CG 20 37 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location And Description Of Completed Operations
Any person or organization that you are required to All insured premises and operations.
add as an additional insured on this policy, under a
written contract or agreement currently in effect, or
becoming effective during the term of this policy.
The additional insured status will not be afforded
with respect to liability arising out of or related to
your activities as a real estate manager for that
person or organization.
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 B. With respect to the insurance afforded to these
include as an additional insured the person(s) or additional insureds, the following is added to
organization(s) shown in the Schedule, but only Section III – Limits Of Insurance:
with respect to liability for "bodily injury" or
"property damage" caused, in whole or in part, by If coverage provided to the additional insured is
"your work" at the location designated and required by a contract or agreement, the most we
described in the Schedule of this endorsement will pay on behalf of the additional insured is the
performed for that additional insured and amount of insurance:
included in the "products-completed operations
hazard". 1. Required by the contract or agreement; or
2. Available under the applicable Limits of
However: Insurance shown in the Declarations;
1. The insurance afforded to such additional whichever is less.
insured only applies to the extent permitted
by law; and This endorsement shall not increase the
applicable Limits of Insurance shown in the
2. If coverage provided to the additional insured is Declarations.
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.
CG 20 37 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 1
POLICY NUMBER: 2024-31443 COMMERCIAL GENERAL LIABILITY
Named Insured: Big Brothers Big Sisters of Metro Atlanta, Inc. CG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s)
Or Organization(s) Location(s) Of Covered Operations
Any person or organization that you are required to All insured premises and operations.
add as an additional insured on this policy, under a
written contract or agreement currently in effect, or
becoming effective during the term of this policy. The
additional insured status will not be afforded with
respect to liability arising out of or related to your
activities as a real estate manager for that person or
organization.
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 2. If coverage provided to the additional insured
include as an additional insured the person(s) or is required by a contract or agreement, the
organization(s) shown in the Schedule, but only insurance afforded to such additional insured
with respect to liability for "bodily injury", "property will not be broader than that which you are
damage" or "personal and advertising injury" required by the contract or agreement to
caused, in whole or in part, by: provide for such additional insured.
1. Your acts or omissions; or B. With respect to the insurance afforded to these
2. The acts or omissions of those acting on your additional insureds, the following additional
behalf; exclusions apply:
in the performance of your ongoing operations for This insurance does not apply to "bodily injury" or
the additional insured(s) at the location(s) "property damage" occurring after:
designated above.
1. All work, including materials, parts or
However: equipment furnished in connection with such
1. The insurance afforded to such additional work, on the project (other than service,
insured only applies to the extent permitted maintenance or repairs) to be performed by
by law; and or on behalf of the additional insured(s) at the
location of the covered operations has been
completed; or
CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 2
2. That portion of "your work" out of which the 2. Available under the applicable Limits of
injury or damage arises has been put to its Insurance shown in the Declarations;
intended use by any person or organization whichever is less.
other than another contractor or subcontractor
engaged in performing operations for a This endorsement shall not increase the
principal as a part of the same project. applicable Limits of Insurance shown in the
Declarations.
C. 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
CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 2 of 2