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ADDITIONAL INSURED — <br />DESIGNATED PERSONS OR ORGANIZATIONS <br />Named hisieetl _...___ -_ <br />Repub4C �m�. Inc. 7Etmersement Number <br />I24 <br />POi y Sym6d Y ri enher Poky Perlad Eftea ve Dale of Endorsement <br />ISA H2554g752 06/3012021 To 06r30C1022 <br />issued ay (Moron w Insurance L;=PWY) <br />ACE American Insurance Company <br />Yadrtlie mmeMardihe lNO IodemmpfeSed emy dss erabrmeMmis. euLsege�mmehe WePaiaRoot as the parry. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies Insurance provided under the follouving: <br />BUSINESS AUTO COVERAGE FORM <br />AUTO DEALERS COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />EXCESS BUSINESS AUTO COVERAGE FORM <br />Additional Insured(s): <br />A. For a covered 'auto,' Who Is insured is amended to include as an Insured,' the persons or organizations <br />narred in lids endorsemerd. However, these persons or organizations are an "Insured" only for'bodiy <br />injury" or -property damage" resulting from acts or omissions of. <br />1. You- <br />2- Any of your "employees' or agents. <br />3. Any person operating a covered'auto' with permission from Many of your'employees' or agents. <br />B. The persons or organizations named in this endorsement are not liable for payment of your premium. <br />f]4-9074c (03.18) <br /><::7iW <br />Authorized Representative <br />RiskMuaganmtDMdDn <br />Cft RtmeAT=Dry&APPRWs� SY- <br />Fl� &,tvik <br />�Rek Management Specialist <br />Of <br />