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10 <br /> ADDITIONAL INSURED — <br /> DESIGNATED PERSONS OR ORGANIZATIONS <br /> Named Insured Werner Enterprises, Inc. Endorsement Number <br /> 1 <br /> Policy Symbol Policy Number Policy Period Effective Date of Endorsement <br /> XSA H 10836190 08/01/2024 To 08/01/2025 <br /> Issued By(Name of Insurance Company) <br /> ACE American Insurance Company <br /> Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> AUTO DEALERS COVERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM <br /> EXCESS BUSINESS AUTO COVERAGE FORM <br /> Additional Insured(s): Any person or organization whom you have agreed to include as an additional insured <br /> under a written contract, provided such contract was executed prior to the date of loss. <br /> A. For a covered "auto,"Who Is Insured is amended to include as an "insured,"the persons or organizations <br /> named in this endorsement. However, these persons or organizations are an "insured" only for"bodily <br /> injury" or"property damage" resulting from acts or omissions of: <br /> 1. You. <br /> 2. Any of your"employees"or agents. <br /> 3. Any person operating a covered "auto"with permission from you, any of your"employees" or agents. <br /> B. The persons or organizations named in this endorsement are not liable for payment of your premium. <br /> Authorized Representative <br /> Rick Managanent Divisim <br /> �?- REVIEWED&APPROVED BY: <br /> A-s-g�e Acevedo <br /> ® Risk Management Specialist <br /> DA-91LI74c(03/16) <br />