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POLICY NUMBER: PSA0001069 <br />COMMERCIAL AUTO <br />CA 2040 1014 <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 under the fcllovtIng: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this andorsoment, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement Identifies person(s) or organization(s) who are "insurads" 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 Coverage Form. <br />This endorsement changes the policy effective on the Inception date of the policy unless another date Is Indicated <br />below. <br />Narnsd insured: dasavtr C.'fruxaw and AesoGatea, Ins. <br />EndarsumatrtEftecttveCtah3; 1013tl2013 <br />SCHEDULE <br />Name p Of ppp Parsonr(p5) Or Organization(s): <br />sp cDl4 Trms axisli aas As ents;v a un�sere, <br />su sadaar as, reprosenta9ves, successors and <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 Liabiltty Coverage, but <br />only to the extent that person or organizafron qualifies <br />as an "Insured" under than Who Is An Insured <br />provision contained in Paragraph A.I. of Section 11-- <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph A.2, of Section I — Covered Autos <br />Coverages of the Auto Dealers Coverage Form. <br />CA 20 40 1013 0Insurance Services Office, Inc., 2011 Page 1 of 1 <br />ixvc, many Tmu +O WUU . anyc A "e 9 <br />25E -39 <br />