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POLICY NUMBER: PSA0001060 <br />COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <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 endoroemont, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) nrorganization(o) who are "inaureda" for Covered Autos Liability <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 />Named Insured: Joseph C. Truxaw and Associates, Inc. <br />Endorsement Effective Date: 10/31/2015 <br />SCHEDULE <br />Name Of Person(s) Or Organization (s): <br />City of Santa Ana, <br />its officers and employees <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />Each person nr organization shown i the Schedule i <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 A1 of Section U <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph D.2. of Section | — Covered Autos <br />Coverages nf the Auto Dealers Coverage Form. <br />CA 20 48 10 13 <br />REVEWED BY- <br />K) Insurance Services Office, Inc., 2011 <br />z,z,oms 1 zo/15'mo*^UTo EXCESS /WC | auwFeue, 1 u/,/wo ,.s`.m nw (PST) | page 3 "^ 5 <br />Page 1 of 1 <br />