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6.1. E. - Page 16 7/10/2013 <br /> PC�LICY NUIVIBER: GLA5761681-00 CQMMEf2CIA� AUTO <br /> CA 20 48 Q2 99 <br /> THIS ENDURSEMENT CHANGES THE P4l,1CY. PL.EASE READ IT CAREFU�LY. <br /> DESIGPIATED INSURED <br /> This endorsement madifies insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> GARAGE COVERAGE FORM <br /> MOTOR CARRIER CC)VERAGE FC)RM <br /> TRUCKERS COVERAGE FORM <br /> With respect to coverage provided by this endorsement, the provisions of the Caverage Form apply uniess modified by <br /> this endorsement. <br /> This endorsement identifies person(s} or organization(s} who are "insureds" under the Wha 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 policy effective an the inceptian date of the policy unless another date is indicated <br /> below. <br /> Endorsement Effective: Countersigned By: <br /> Named Insured: Moffatt & Nichol <br /> Authorized Re resentative <br /> SCHEQULE <br /> Name of Person(s) or Organization{s}: <br /> ANY PERSC}N dR ORG�TIZATION TO WHOM OR WHICH YOU ARE REQUIRED TO <br /> PRC}VIDE ADDITIONAL INSURED STATUS OR ADDITIONAL INSURED STATUS ON A <br /> PRIMARY, NUN-CONTRIBUTQRY 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, informatian required to complete this endorsement will be shown in the Declaratians as <br /> applicable to the endorsement.) <br /> Each persan or arganization shown in the Schedule is an "insured" for �iability Goverage, but only to the extent that <br /> person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Sectian 11 of the <br /> Caverage Form. <br /> CA 20 48 02 99 Copyright, insurance Services Office, Inc., 1998 Page 1 of 1 ❑ <br /> CERT NO.: 16965522 Sally E. Kerr 7/10/2013 9:36:58 AM Page 4 of 4 <br />