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SCHEDULE <br /> Name Of Additional Insured Person(s) <br /> Or Or anization s Location s Of Covered O erations <br /> Any Person or Organization to whom you become Per the contract or agreement <br /> obligated to include as an Additional Insured as a <br /> result of any contract or agreement you enter into. <br /> Information re uired to com lete this Schedule, if not shown above, will be shown in the Declarations. <br /> CG 20 10 04� 13 O Insurance Services Office, Inc., 2012 Page 2 of 2 <br />