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POLICY NUMBER:AS1-B71-170821-056 COMMERCIAL AUTO <br /> CA 20 48 10 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 after coverage <br /> provided in the Coverage Form. <br /> SCHEDULE <br /> Name Of Persons Or Organization(s): <br /> Any person or organization whom you have agreed in writing to add as an additional insured,but only to <br /> 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 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 0.2.of <br /> Section I - Covered Autos Coverages of the Auto <br /> Dealers Coverage Form. <br /> CA 20 48 10 13 0 Insurance Services Office,Inc.,2011 Page 1 of 1 <br />