Laserfiche WebLink
POLICY NUMBER: BAP347266912 COMMERCIAL AUTO <br /> CA 20 48 02 99 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE HEAD IT CAREFULLY. <br /> DESIGNATED INSURED <br /> This endorsement modifies Insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> GARAGE 00VERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM <br /> TRUCKERS COVERAGE FORM <br /> With respect to coverage provided by this endorsement,the provisions of the Covelage Form apply unless modified by <br /> this endorsement. <br /> This endorsement Identifies person(s) or organization(a) who are"Insureds"under the Who Is An Insured Provision of <br /> the Coverage Form.This endorsement does not alter coverage provided In the Coverage Form. <br /> This endorsement changes the polloy effeotive on the Inception date of the policy unless another date is Indloated <br /> below, <br /> Endorsem rit EM five Countersigned By; <br /> Sept:ernJ34 3I, X013 (� <br /> N 'raniterROCk Company 91L <br /> (Authorized Re re ntative <br /> SCHEDULE <br /> Name of Person(*)or Orgentration(s): <br /> ANY PERSON OR ORGANIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO <br /> PROVIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A <br /> PRIMARY, NON CONTRIBUTORY BASIS, IN A WRITTEN CONTRACT OR WRITTEN <br /> AGREEMENT. EXECUTED PRIOR TO LOSS, EXCEPT WHERE SUCH CONTRACT OR <br /> AGREEMENT IS PROHIBITED BY LAW. <br /> (if no entry appears above, Information required to complete this endorsement will be shown In the Declarations as <br /> applicable to the endorsement.) <br /> Each person or organization shown In the Schedule Is an 'insured"for Liability Coverage,but only to the extent that <br /> person or organization qualifies as an"Insured"under the Who is An Insured Provision contained In Section 11 of the <br /> Coverage Form. <br /> CA 20 48 02 89 Copyright, Insurance Services Office, Inc., 1898 Page 1 of 1 O <br /> Inured Copy <br />