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POLICY NUMBER: ACP 7816214975 <br />COMMERCIAL AUTO <br />CA 20 48 0299 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOIORCARRIERCOVERAGEFORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- <br />fied by this endorsement. <br />This endorsement identifies persons) or organization(s) who are insureds under the Who Is An Insured Provision <br />of the Coverage Form. This endorsement does not alter coverage 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 />Endorsement Effective; 7119/14 <br />Countersigned �By: <br />�/I �wt.W v 1. iS/�WwYI <br />(Authorized <br />Named Insured: B & D TOWING. INC. <br />6141.4 idfllFal <br />Name of Person(s) or Organization(s): <br />The City of Santa Ana, its officers, employees, agents, volunteers and representatives <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as <br />applicable to the endorsement) <br />Each person or organization shown in the Schedule is an insured for Liability Coverage, but only to the extent <br />that person or organization qualifies as an insured under the Who Is An Insured Provision contained <br />in Section II of the Coverage Form. <br />jj <br />CA 20 48 0299Copyright, Insurance Services Office, Inc., 1998 Page I of 1 13 <br />