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68114157 <br /> POLICY NUMBER: NC970920 COMMERCIAL GENERAL LIABILITY <br /> CG 20 12 05 09 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED - STATE OR GOVERNMENTAL <br /> AGENCY OR SUBDIVISION OR POLITICAL <br /> SUBDIVISION - PERMITS OR AUTHORIZATIONS <br /> This endorsement modifies insurance provided under the following: <br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART <br /> SCHEDULE <br /> State Or Governmental Agency Or Subdivision Or Political Subdivision: <br /> CITY OF CENTERVILLE DIVA DASH <br /> 1880 MAIN ST <br /> CENTERVILLE MN 55038 <br /> Il i <br /> I <br /> information required to complete this Schedule if not shown above will be shown in the Declarations. <br /> Section 11 — Who Is An Insured is amended to in- 2. This insurance does not apply to: <br /> clude as an insured any state or governmental <br /> a. "Bodily injury", " property damage " or personal <br /> agency or subdivision or political subdivision shown in " <br /> and advertising injury arising out of operations <br /> the Schedule, subject to the following provisions: performed for the federal government, state or <br /> 1. This insurance applies only with respect to opera- municipality; or <br /> tions performed by you or on your behalf for which b. "Bodily injury" or "property damage" included <br /> the state or govemmental agency or subdivision or within the "products - completed operations <br /> political subdivision has issued a permit or au- hazard ". <br /> thorization. <br /> CO 2012 05 09 0 Insurance Services Office, Inc., 2008 Page 1 of 1 ❑ <br />