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POLICY NUMBER: 649',28948 <br />COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />X*1Tj4:A9�M4r-A1:j14k" "#:I <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 person(s) or arganization(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 of on the inception date of the policy unless another date is indicated <br />below, <br />Named Insured: RI ENTERPRISES INC DBA,- HJELMSTROM & ASSOCIATES <br />Endorsement Effective Date: 1C-01-2015 <br />SCHEDULE <br />Name Of' Persons) Or Organizadoni(s): <br />CITY OF SANTA ANA <br />20 CIVIC CENTER P--Z <br />SANS TA ANA, CA USA 92711,14058 <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.1. of Section III — <br />Covered Autos Liability Coverage in the Business <br />Auto and Motor Carrier Coverage Forms and <br />Paragraph 13.2. of Section I — Covered Autos <br />Coverages of the Auto Dealers Coverage Form. <br />CA 20 48 1013 @ Insurance Services Office, Inc., 2011 Page I of I <br />. ... ....... .. <br />ElRflCl� HEFIEiDiA <br />............. <br />