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POLICY NUMBER: AS2-611-B8T8Z6-069 COMMERCIAL AUTO <br /> CA20481013 <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 this 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 /> Blanket-Any person or organization whom you have agreed in writing to add as an Additional Insured but only <br /> to coverage and minimum limits of insurance required by the written agreement,and in no event to exceed either <br /> the scope of coverage or the limits of insurance provided in this policy. <br /> Information re uired to com lete 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 <br /> provision contained in Paragraph A.1. of Section II — <br /> Covered Autos Liability Coverage in the Business <br /> Auto and Motor Carrier Coverage Forms and <br /> Paragraph D.2. of Section I — Covered Autos <br /> Coverages of the Auto Dealers Coverage Form. <br /> CA 20 48 10 13 O Insurance Services Office, Inc., 2�11 F�age 1 of 1 <br />