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POLICY NUMBER: AS2-Z91-466837-010 <br />COMMERCIAL AUTO <br />AC 84 67 04 15 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />BLANKET ADDITIONAL INSURED <br />This endorsement modifies insurance provided under the 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 this endorsement, the provisions of the Coverage Form apply unless <br />modified by the endorsement. <br />The following is added to Who Is An Insured of Section II - Liability Coverage: <br />Any person or organization with whom you agreed, because of a written contract, written agreement or <br />written permit, to provide insurance such as is afforded under this Coverage Form. This provision only <br />applies if the written contract or written agreement has been executed or written permit issued prior to the <br />"bodily injury" or "property damage". <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />G 2014 Liberty Mutual Insurance <br />AC 84 67 04 15 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 'I Of 1 <br />