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POLICY NUMBER: PSA0001069 <br />COMMERCIAL AUTO <br />CA 20 40 10 13 <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 following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies persons) or organization(s) who are "insureds" 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 elate is indicated <br />below. <br />',. Named IBSUfed: Joseph C. Tmxaw and Associates, Inc, <br />End orsomont Effective Data; 1 0131 /2 01 3 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />-For pproporal Pu�poses -Mote: Nor�- <br />sp u[flc t4rms suc as agen s, velun eers, <br />subsidiaries, representatives, 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 Liability Coverage, but <br />only to the extent that person or organization qualifies <br />as an "insured" under the Who Is An Insured <br />provision contained in Paragraph A.I. of Section II — <br />Covered Autos Liability Coverage In the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph D.2. of Section I — Covered Autos <br />Coverages of the Aldo Dealers Coverage Form. <br />CA 20 40 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />IA", ll,r, Trio, 1.011 2011 ..16.19 .I 9 J.' 1 ,4 1 <br />