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BUSINESS AUTO COVERAGE FORM <br /> I. NEWLY ACQUIRED OR FORMED ENTITY(Broad Farm Named Insured) <br /> SECTION II -LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: <br /> d. Any business entity newly acquired or formed by you during the policy period <br /> provided you own 50%or more of the business entity and the business entity is not <br /> separately insured for Business Auto Coverage.Coverage is extended up to a <br /> maximum of 180 days following acquisition or formation of the business entity. <br /> Coverage under this provision is afforded only until the end of the policy period. <br /> Coverage does not apply to an"accident"which occurred before you acquired or <br /> formed the organization. <br /> II. EMPLOYEES AS INSUREDS <br /> SECTION II- LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: <br /> e. Any"employee" of yours is an "insured"while using a covered "auto"you don't <br /> own, hire or borrow in your business oryour personal affairs. <br /> III. AUTOMATIC ADDITIONAL INSURED <br /> SECTION II-LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: <br /> f. Any person or organization that you are required to include as additional insured <br /> on the Coverage Form in a written contract or agreement that is signed and <br /> executed by you before the"bodily injury" or"property damage" occurs and that is <br /> in effect during the policy period is an "insured"for Liability Coverage, but only for <br /> damages to which this insurance applies and only to the extent that person or <br /> organization qualifies as an"insured" under the Who Is An Insured provision <br /> contained in Section II. <br /> IV. EMPLOYEE HIRED AUTO LIABILITY <br /> SECTION II- LIABILITY COVERAGE,A. Coverage, 1.Who Is An Insured,the following is added: <br /> g. An "employee" of yours is an "Insured" while operating an "auto" hired or rented <br /> under a contract or agreement in that "employee's" name,with your permission, <br /> while performing duties related to the conduct of your business. <br /> V. SUPPLEMENTARY PAYMENTS <br /> SECTION II—LIABILITY COVERAGE,A. Coverage, 2. Coverage Extensions, a.Supplementary <br /> Payments,Subparagraphs(2) and (4) are replaced by the following: <br /> (2) Up to$3,000 for cost of bail bonds(including bonds for related traffic law <br /> violations) required because of an "accident"we cover. We are not obligated to <br /> furnish these bonds. <br /> (4) All reasonable expenses incurred by the "insured" at our request, including <br /> actual loss of earnings up to$500 a day because of time off from work. <br /> Copyright 2017 Mercury Insurance Services,LLC. All rights reserved. <br /> MCA85100817-CA Includes copyrighted material of Insurance Services Office,Inc.,with its Permission Page 2 of 6 <br /> i <br />