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POLICY NUMBER: DT-810-0728C301-TIL-06 COMMERCIAL AUTO <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply <br />unless modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured <br />Provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage <br />Form. <br />SCHEDULE <br />Name of Person(s) or Organization(s): <br />ANY PERSON OR ORGANIZATION WHOM YOU HAVE <br />AGREED IN A WRITTEN CONTRACT, EXECUTED <br />PRIOR TO LOSS AND IN EFFECT DURING THIS <br />POLICY PERIOD, TO NAME AS ADDITIONAL <br />INSURED. <br />(If no entry appears above, information required to complete this endorsement will be shown in the <br />Declarations as applicable to the endorsement) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the <br />extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision <br />contained in Section II of the Coverage Form. <br />APPROVED AS TO FORM <br />B JAMIN FM N <br />Chief Assistant City Attorney <br />CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 <br />