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THIS FORM APPLIES iN STATES WHICH USE:CA 00 01 (031 D) <br /> IL 10 (12!06) OLD REPUBLIC INSURANCE COMPANY <br /> THIS ENDORSEMENT CHANGES THE POLICY,PLEASE READ IT CAREFULLY. <br /> 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 /> SCHEDULE <br /> Name of Person(s) or Organization(s): <br /> All persons or organizations as required by contract or agreement <br /> • <br /> With respect to LIABILITY COVERAGE,Who is An Insured is changed with the addition of the following: <br /> Each person or organization shown in the Schedule for whom you are doing work is en "Insured". But <br /> only for "bodily Injury" or"property damage" that results from The ownership, maintenance or use of a <br /> covered"auto"by: <br /> 1. You; <br /> 2. an"employee" of yours; or <br /> S. anyone who drives a covered "auto"with your permission or with the permission of one of your <br /> "employees". <br /> However, the insurance afforded to the person or organization shown In the Schedule shall not exceed <br /> the scope of coverage and/or limits of this policy. Not withstanding the foregoing sentence, In no event <br /> shall the Insurance provided by this policy exceed the scope of coverage and/or limits required by the <br /> contract or agreement. <br /> PCA 001 03 06 <br /> MW76 21043 ReRgrow;and charitable Risk Pooling Trost 08/15/2017.06/18/2010 <br /> /1p2P,e0Ver, at-z--v-' 2 Prat' <br />