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Copyright 2017 Mercury Insurance Services, LLC. All rights reserved. <br />MCA85100817-CA Includes copyrighted material of Insurance Services Office, Inc., with its Permission Page 2 of 6 <br /> <br />BUSINESS AUTO COVERAGE FORM <br /> <br />I. NEWLY ACQUIRED OR FORMED ENTITY (Broad Form Named Insured) <br /> SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: <br /> d. Any business entity newly acquired or formed by you during the policy period <br /> provided you own 50% or more of the business entity and the business entity is not <br /> separately insured for Business Auto Coverage. Coverage is extended up to a <br /> maximum of 180 days following acquisition or formation of the business entity. <br /> Coverage under this provision is afforded only until the end of the policy period. <br />Coverage does not apply to an “accident” which occurred before you acquired or <br />formed the organization. <br /> <br />II. EMPLOYEES AS INSUREDS <br /> SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: <br />e. Any “employee” of yours is an "insured" while using a covered “auto" you don't <br /> own, hire or borrow in your business or your personal affairs. <br /> <br />III. AUTOMATIC ADDITIONAL INSURED <br />SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: <br />f. Any person or organization that you are required to include as additional insured <br /> on the Coverage Form in a written contract or agreement that is signed and <br /> executed by you before the "bodily injury" or "property damage" occurs and that is <br /> in effect during the policy period is an "insured" for Liability Coverage, but only for <br /> damages to which this insurance applies and only to the extent that person or <br /> organization qualifies as an "insured" under the Who Is An Insured provision <br /> contained in Section II. <br /> <br />IV. EMPLOYEE HIRED AUTO LIABILITY <br />SECTION II - LIABILITY COVERAGE, A. Coverage, 1. Who Is An Insured, the following is added: <br />g. An "employee" of yours is an "insured" while operating an "auto" hired or rented <br />under a contract or agreement in that "employee's" name, with your permission, <br />while performing duties related to the conduct of your business. <br /> <br />V. SUPPLEMENTARY PAYMENTS <br /> SECTION II – LIABILITY COVERAGE, A. Coverage, 2. Coverage Extensions, a. Supplementary <br /> Payments, Subparagraphs (2) and (4) are replaced by the following: <br />(2) Up to $3,000 for cost of bail bonds (including bonds for related traffic law <br /> violations) required because of an "accident" we cover. We are not obligated to <br /> furnish these bonds. <br />(4) All reasonable expenses incurred by the "insured" at our request, including <br /> actual loss of earnings up to $500 a day because of time off from work. <br /> <br />Docusign Envelope ID: 343D145E-2FCA-415A-85EB-2B28A2247676