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POLICY NUMBER: BAP8311663-15 <br />COMMERCIAL AUTO <br />CA20481013 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED FOR <br />COVERED AUTOS LIABILITY COVERAGF <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage <br />provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: ZIM INDUSTRIES, INC. <br />Endorsement Effective Date: 3/1/2019 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO <br />PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A <br />PRIMARY, NON-CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN <br />AGREEMENT EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR <br />AGREEMENT IS PROHIBITED BY LAW <br />this <br />Each person or organization shown in the Schedule is <br />an "insured" for Covered Autos Liability Coverage, but <br />only to the extent that person or organization qualifies <br />as an "insured" under the Who Is An Insured provision <br />contained in Paragraph A.I. of Section 11 — Covered <br />Autos Liability Coverage in the Business Auto and <br />Motor Carrier Coverage Forms and Paragraph D.2. of <br />Section I — Covered Autos Coverages of the Auto <br />Dealers Coverage Form. <br />CA 20 48 10 13 <br />4 <br />© Insurance Services Office, Inc., 2011 <br />Tit <br />Page 1 of 1 <br />