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POUCY NUMBER: ACP 7826214975 COMMERCIAL AUTO <br />CA 20 48 M9 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement modifies insaranoc provided under the Ulowing: <br />9USiRIESS AUTO C(n's'%RAGE FOPM <br />t3AR.S(3E COVERAGE FORM <br />NiXORt CARRTFRC(WM4,(TT(W <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsemenl, Lae prov€siuns of the Coverage Forret apply unless modi- <br />fied. Ly this endorsemant. <br />This endorsementidentifies person(s) or organi;..ation(sl who are insureds under the Who Is An Insured Provision <br />of the I.'.overa;a Flinn, T'hirc and�orsematr4 does not altere:ervor».ge provided in t#�e f;avarrtge Form. <br />This endorsement changes the policy effective on fisc inception date of the policy date is indicated <br />below. <br />nsurett: B &:. D T'OWIN0, INC'., <br />SCI IEDUIE <br />Name of Personts) or Orgaoizathsn(s): <br />rhe city of Santa Ana, its officers, ennploym, agents, volunteers suaal representatives <br />(I£ ne entry appears above, information required to comfier€ this endorsement will be shown in the Declarations as <br />applicable to't6e endorsement.) <br />Each person or organization shown in the Schedule is un. insured for Liability Cover -.$e, but only to the extent <br />that person or organization qualifies as an insured under the Who Is An Insured Provision contained <br />in sectiml R of'the.. Coverag3 Fo:sn. <br />CA 20 48 0299Copyright, insurance Seances Office, Inc,, 1999 Page I of I 0 <br />