BURGESS MOVING & STORAGE (INLAND MOVING & STORAGE, CO., ONC.)

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INSURED: Inland Moving and Storage Co. Adam ® TRANSGUARD, Irv:l�N6�t[ « 1�IPiilt VI A11(XIL1. /':[. COMMERCIAL AUTO 014108 04118 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — BLANKET This endorsement modifies insurance provided under the following: MOTOR CARRIER COVERAGE FORM This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective Date: Policy Number: 04/01/2024 TCP 01103 5720 A. Additional Insured Coverage 1. SECTION II — COVERED AUTOS LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, is amended to include as an "insured" the person(s) or organization(s) with respect to the ownership, maintenance, or use of a covered "auto", other than: (1) A "van line" that is party to a written agreement with you that appoints you as its agent for purposes of providing moving and relocation services; or (2) A "van line' that is scheduled on any Additional Insured — Van Line endorsement to this policy; and further provided that you have agreed to add such person or organization as an additional "insured" pursuant to an express provision in a written "insured contract' or other written agreement, or in a permit issued to you by a governmental or public authority. Any person or organization is an additional "insured" solely with respect to "bodily injury" or "property damage' caused by an "accident' arising out of: (1) The ownership, maintenance or use of a covered "auto'; and (2) Your operations under the "insured contract', other written agreement, or permit that takes place after: (a) You executed the "insured contract' or written agreement; or (b) The permit has been issued to you; and then only to the limited extent and for no higher limits of insurance required in such "insured contract', other written agreement, or permit. B. Definitions For purposes of this endorsement only, the following definition is added: 1. Van Line means a person or organization for which you have been appointed as an agent for purposes of providing moving and relocation services. All other terms and conditions of the policy remain the same. Riek MnwgemgLL Dlrialan REVIEWID 6 APPROVED BY. �� fIC�V�/SO Risk Management Specialist TRANSGUARD INSURANCE COMPANY OF AMERICA, INC. 014108 04118 Includes copyrighted material of Insurance Services Office, Inc., with its permission.