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POLICYNUMBER: (i71735G-fit._ ;I <br />2p)( 09D <br />COMMERCIAL AUTO <br />CA 20 48 02 99 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED 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 modified by <br />this endorsement. <br />This endorsement identifies person(s) or organization(s) who are 'Insureds" under the Who Is An Insured Provision of <br />the Coverage Form. This endorsement does not alter coverage 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 />below. <br />Endorsement Effective: Countersigned By - <br />Named Insured: <br />Authorized Representative) <br />SCHEDULE <br />Name of Person(s) or Organization(s): <br />CESISNATED PERSON OR ORGANIZATION PERSONS OR ORGANIZATIONS THAT YOU <br />ARE OBLIGATED,. PURSUANT TO WRITTEN CONTRACT OR AGREEMENT BETWEEN YOU <br />AND SUCH PERSON OR ORGANIZATION, TO PROVIDE WITH SUCH INSURANCE AS IS <br />AFFORDED BY THIS POLICY; BUT THEY ARE INSURED'S ONLY IF AND TO THE <br />MINIMUM EXTENT THAT SUCH CONTRACT OR AGREEMENT REQUIRES THE PERSON OR <br />ORGANIZATION TO BE AFFORDED STATUS AS AN INSURED. HOWEVER, NO PERSON <br />OR ORGANIZATION IS AN INSURED UNDER THIS PROVISION: WHO IS MORE <br />SPECIFICALLY DESCRIBED UNDER ANY OTHER. PROVISION OF THE WHO IS AN <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as <br />applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an 'Insured" for Liability Coverage, but only to the extent that <br />person or organization qualifies as an 'insured" under the Who Is An Insured Provision contained in Section II of the <br />Coverage Form. <br />CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ❑ <br />3ISI18, f'�t)z 2 of S <br />