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CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />POLICY NUMBER: AS2-661-067353-023 COMMERCIAL AUTO <br />CA 20 48 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED FOR 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 />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 <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 />Docusign Envelope ID: AE6D62F6-F8A3-4FE3-ABFB-CC69763A0B44