Laserfiche WebLink
POLICY NUMBER: PSA0001078 <br />COMMERCIAL AUTO <br />CA 20 48 02 99 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED 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 />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- <br />sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indi- <br />cated below. <br />Endorsement Effective: 11/30/2011 Countersign• X4�,�,._, <br />Named Insured: Johnson Frank & Associates, Inc. <br />Authorized Representative) <br />SCHEDULE <br />Name of Pemon(s) or Organlzatlon(s): <br />City of Santa Ana, Its Officers and Employees <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br />as applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent <br />that person or organization qualifies as an "insured' under the Who Is An Insured Provision contained <br />in Section 11 of the Coverage Form. <br />CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 ❑ <br />C6RT NO.: 11750526 Teresa Frank 11/30/2011 4:20:07 PM Page 3 Of 4 <br />