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Policy: 72APDO10186 M-5876(0512016) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE. READ IT CAREFULLY. BLANKET ADDITIONAL INSURED! ENDORSEMENT This endorsement modifies insurance provided under the following: B:U8INESS AUTO COVERAGE FORM GARAGE COVERAGE FORM TRUCKERS COVERAGE FORM In consideration of payment,of the additional prom,ium listed'below,LIABILITY COVERAGE is extended to any person or organization you are required.to add to this poicy as an additionali insured irr a written agreement between you and then additional insured that is executed prior to the"accident"provided that:. 1) such insurance applies only to the ownership, maintenance or use of a covered auto; and 2') such insurance applies only to.acts or omissions by you,,your agents or your"employees"while such covered auto is being used in.your business;and 3) such insurance does not apply to the acts or omissions of the:additional insured or any of the additional insured's agents or"employees"other than you; and 4) such insurance does not apply if the additional insured is subject to motor carrier insurance requirements and is not insured for hired"autos"un.deran"auto"liability insurance form that insures on a primary basis the owners of the"autos"and:their agents and"employees"while the.„autos"are being used exclusively in the additional insured's business and pursuant to operating rights granted to the additional insured by a public!authority; and 5) such inclusion of additional insured shall not increase our limit of Iiabil'ity under this policy. All other terms, conditions and agreements remain unchanged. Additional Premium: $ CompanyiVame Poky Number Endorsement.Effective Named li)sured Countersigned by tAuthorized Representative) Jh.a Attaching:Clause need be.completed ansy when this endorsement is issued subsoquent to preparation of the poacy.) M-5076(05'1201'6)