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POLICY NUMBER:AS7-651-004227-075 COMMERCIAL AUTO <br /> CA 20 4810 13 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> DESIGNATED INSURED FOR <br /> COVERED AUTOS LIABILITY COVERAGE <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 <br /> modified by the endorsement. <br /> This endorsement identifies person(s) or organization(s)who are"insureds" for Covered Autos Liability Coverage <br /> under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage <br /> provided in the Coverage Form. <br /> SCHEDULE <br /> Name Of Person(s) Or Organization(s): <br /> Any person or,organization whom you have agreed in writing to add as <br /> an additional insured, but only to coverage and minimum limits of <br /> insurance required by the written agreement, and in no event to exceed <br /> either the scope of coverage or the limits of insurance provided in <br /> this policy. <br /> Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <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.I. of Section II - 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 /> CA 20 4810 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 <br />