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Attachment Code: D563844 Certificate ID: 16059509 <br />Policy Number: 72UENOL5481 <br />Policy Term: 2/1 /2021 to 2/1 /2023 <br />COMMERCIAL AUTOMOBILE <br />HA 99 16 0312 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />COMMERCIAL AUTOMOBILE BROAD FORM <br />ENDORSEMENT <br />This endorsement modifies insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other <br />provisions of the Coverage Form, the provisions of this endorsement apply. <br />1. BROAD FORM INSURED d. Any "employee" of yours while using a <br />A. Subsidiaries and Newly Acquired or covered "auto" you don't own, hire or <br />Formed Organizations borrow in your business or your <br />The Named Insured shown in the personal affairs. <br />Declarations is amended to include: C. Lessors as Insureds <br />(1) Any legal business entity other than a <br />partnership or joint venture, formed as a <br />subsidiary in which you have an <br />ownership interest of more than 50% on <br />the effective date of the Coverage Form. <br />However, the Named Insured does not <br />include any subsidiary that is an <br />"insured" under any other automobile <br />policy or would be an "insured" under <br />such a policy but for its termination or <br />the exhaustion of its Limit of Insurance. <br />(2) Any organization that is acquired or <br />formed by you and over which you <br />maintain majority ownership. However, <br />the Named Insured does not include any <br />newly formed or acquired organization: <br />(a) That is a partnership or joint <br />venture, <br />(b) That is an "insured" under any other <br />policy, <br />(c) That has exhausted its Limit of <br />Insurance under any other policy, or <br />(d) 180 days or more after its <br />acquisition or formation by you, <br />unless you have given us notice of <br />the acquisition or formation. <br />Coverage does not apply to "bodily <br />injury" or "property damage" that results <br />from an "accident" that occurred before <br />you formed or acquired the organization. <br />B. Employees as Insureds <br />Paragranh A_1 _ - WHO IS AN INSURED - of <br />SECTION II - LIABILITY COVERAGE is <br />amended to add: <br />Paragraph A.1. - WHO IS AN INSURED - of <br />Section II - Liability Coverage is amended to <br />add: <br />e. The lessor of a covered "auto" while the <br />"auto" is leased to you under a written <br />agreement if: <br />(1) The agreement requires you to <br />provide direct primary insurance for <br />the lessor and <br />(2) The "auto" is leased without a driver. <br />Such a leased "auto" will be considered a <br />covered "auto" you own and not a covered <br />"auto" you hire. <br />D. Additional Insured if Required by Contract <br />(1) Paragraph A.1. - WHO IS AN INSURED <br />- of Section II - Liability Coverage is <br />amended to add: <br />f. When you have agreed, in a written <br />contract or written agreement, that a <br />person or organization be added as <br />an additional insured on your <br />business auto policy, such person or <br />organization is an "insured", but only <br />to the extent such person or <br />organization is liable for "bodily <br />injury" or "property damage" caused <br />by the conduct of an "insured" under <br />paragraphs a. or b. of Who Is An <br />Insured with regard to the <br />ownership, maintenance or use of a <br />covered "auto." <br />© 2011, The Hartford (Includes copyrighted material <br />Form HA 99 16 03 12 of ISO Properties, Inc., with its permission.) <br />ew cF IZAMwagzmedDiAsian <br />Jy/ 1'x REVIEWED & APPROVED BY: <br />V"° <br />--� Risk janagement Analyst <br />