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POLICY NUMBER: <br />COMMERCIAL AUTO <br />CA 20 48 07 97 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED INSURED <br />This endorsement modifies insurance provided under the following; <br />BUSINESS AUTO COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless mod- <br />ified by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An insured provi- <br />sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated <br />below. <br />Endorsement Effective: 12/31/2011 Countersigned By; <br />Named Insured: Brown Brothers Plumbing <br />SCHEDULE <br />Dame of Person(s) or Organization(s): <br />Any or All Person(s) or Organization(s) as required by written /executed contract, for jobs in the state of. North <br />Carolina. <br />(If no entry appears above, Information required to complete this endorsement will be shown in the Declarations <br />or above Schedule as applicable to the endorsement.) <br />Each person or organization indicated above 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 ti <br />of the Coverage Form. <br />CA 20 48 07 97 Copyright, Insurance Services Office, Inc., 1996 <br />. Page 1 of I ❑ <br />