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POLICY NUMBER: BAP557108812 <br />7131 /2024 <br />COMMERCIAL AUTO <br />CA 20 48 10 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 underthe 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 Covorago 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: All American Asphalt <br />Endorsement Effective Date:08/0112024 <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 ON A PRIMARY, NON-CONTRIBUTORY <br />BASIS, IN A WRITTEN CONTRACT OR WRITTEN AGREEMENT EXECUTED PRIOR TO <br />LOS5, EXCEPT WHERE SUCH CONTRACT OR AGREEMENT IS PROHIBITED BY LAW. <br />Information 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.1. of Section II — 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 />SCHEDULE: <br />City of Santa Ana <br />OO Insurance Services Office, Inc , 2011 <br />Risk M>zrlage..d vmsian <br />REVIEWED & APPROVED BY: <br />RIskR4anagementSpecjAist .: <br />81239342 124 t0[1 Standard with S5m XS I Michael Mendoza 17i3l72024 11:18:51 AM (PDT) I Page 9 of I I <br />