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POLICYNUMBER B.AP 5 365893 0b <br />AUTO <br />COMMERCIAL <br />CA 20 48 02 89 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />This endorsement modifies insurance provided underthe 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 thl.: endorsement, the provlslons of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(5) who are "Insureds" under the Who Is An Insured Provi- <br />sion of the Coverage Forro. This endorsernent 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 indi- <br />cated below, <br />Endorsement Effective: 419113 Countersigned By: <br />Pdamed Insured: <br />AEG;010 Technical Services Inc. (Authorized Representative) <br />SCHEDULE <br />of Person(si or Organixatiorl <br />ONLY THOSE WHERE REQUIRED BY WRITTEN CONTRACT. <br />(If no entry appears above, Information required to completer this endorc�orrierit will be shown In the Declal ations <br />as 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 10/ho Is An Insured Provision contained In <br />Section II of tile. Coverage Form. <br />Copyright, Hawaii Insurance Bureau, Inc., 1999 <br />Includes copyrighted material of the <br />Insurance Services Office, Inc., with Its permission CA 1028 (2-99) <br />CA 20 48 02 99 Copyright, Insurance Seroces Office, Inc., 1999 Page 1 of 1 <br />