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POLICY NUMBER: RAD500047602 <br />COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <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 modified by <br />this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under <br />the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the <br />Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Named Insured: FALCK USA, Inc. <br />Endorsement Effective Date: October 1, 2017 <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <br />Where required by written contract executed prior to loss. <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 provision <br />contained in Paragraph A.1. of Section If — Covered <br />Autos Liability Coverage in the Business Auto and <br />Motor Carrier Coverage Forms and Paragraph D.2. of <br />Section I — Covered Autos Coverages of the Auto <br />Dealers Coverage Form. <br />1//z - Ill 7 <br />1"I"I <br />Aa,y `r/s <br />4ev, eIe(t <br />CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 / <br />