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Human Resources Department

Liability & Insurance

Sample Form 7: Additional Insured – Designated Person or Organization

Liability & Insurance 750

Name Of Additional Insured Person(s) Or Organization(s) -Not acceptable if left blank. Must show the name of the additional insured or “by contract”.
This additional insured endorsement is acceptable for all situations except when we require additional insured status for completed operations. Sample Form 5 is used for that situation.
A. Section II - Who Is An Insured is amended to include as an additional insured:"in the performance of your ongoing operations; or in connection with your premises owned by or rented to you."