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POLICY NUMBER: AS1-671-171213-011 <br />COMMERCIAL AUTO <br />CA 20 4810 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED FOR <br />COVERED AUTOS LIABILITY COVERAGE <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 the 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 />Name <br />required by written contract <br />SCHEDULE <br />Ilnformation required to complete this Schedule, if not shown above, will be shown in the Declarations. <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 0 Insurance Services Office, Inc., 2011 <br />xm o� <br />R+nEvrID6APRroJm By. <br />7ou �4sao.r <br />imxma,,,ye,R,namuianr <br />