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<br /> <br />L I. <br /> <br />Corporati.on. <br /> <br />e. Memher ofLlbert:r Muru:tl Group <br />Liberty Surplus Insurance Corporation <br /> <br />ENDORSEMENT <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br />Endorselnent Effective Date: 10/01/09 Policy No.: DGL-SF-079259-064 <br />Insured: Ferma Corporation <br /> <br />ADDITIONAL INSURED -OWNERS.. LESSEES <br />OR CONTRACTORS - COMPLETED OPERATIONS <br /> <br />SCHEDULE <br /> <br />Name of Person or Organization: <br />As required by written contract signed by both parties prior to any "occurrence" <br /> <br />in which coverage is sought under this policy <br /> <br />Location and Description of Completed Operations: <br /> <br />Additional Premium: <br /> <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to this endorsement.) <br /> <br />CGL 1038 1103 <br /> <br />Page 1 of2 <br />