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<br />Mar. 2. 2010 lO:,UAM <br /> <br />OAV1~ KIGHAKD GUULD <br /> <br />No. 0223 P. 3 <br /> <br />POueY NUMBER: 604764540 <br /> <br />COMMERCIAL AUTO <br />CA 20 48 02 99 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. P~eASE READ IT CAREFULLY. <br /> <br />DESIGNATED INSURED <br /> <br />ThIs endorsement modifies insurance provided under the following: <br /> <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAaI: FORM <br />MOTOR CARRIER COvEftAGE FORM <br />TRUCKERS CQVI!RAGE FORM <br /> <br />With respect to coverage provided by thie .ndor.er'nent, the pmvi810ns Of the COverage Form apply unl.. <br />modified by lhla endorwment. <br /> <br />This endorsement Iden1ltle8 person(s) or organlzation(s) who are "insuredgP under the Who Is An Insured ProW. <br />!lion of the Coverag& Fotm. This ~doreernent does not f;1Uer coverage provided in the Coverage Form. <br /> <br />ThI9 encJoreemeot Changes the policy affective on the Inception elate of the policy unless another date IS intir. <br />catoo below. <br /> <br />Endorsament Effecti~e: Countersigned By: <br />03101/2010 <br />Namect Insured: <br />ROOfiNG RESPONSIBl Y (AuthOrt%ed ReDreeentattve) <br /> <br />SCHEDULE <br />I Name Of Pereon(8) or Organlllltloll(s): CllY Of REIJIMJOO CITY <br /> <br /> <br /> <br /> <br />(If no entry appean; above, Information required to complete thls endorsement will be shown '0 the Deolarations <br />as applJtlf)le to 1111 enCiOrsement) <br /> <br />Each person or organization shown In tt1e Schedule IS an Ilmsured" for liability Coverage. but only to the extent <br />that pereon or organlzatlon qualifies as an "insured" under the Who Is An Insured Provision contained <br />In Section II of the Coverage Form. <br /> <br />CA 20 48 02 99 <br /> <br />Copyright. Inauf8noe S~rv1ceS Ortlce. inco. 1998 <br /> <br />page 1 Of1 C <br />