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DocuSign Envelope ID: E67DC299-98E1-4682-B281-3085AC9FC5B4 <br /> Business Auto Policy <br /> CNA_ Policy Endorsement <br /> I IBM;ED 11 11D 0 Na I-is <br /> N <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> This endorsement modifies insurance provided under the following: <br /> AUTO DEALERS COVERAGE FORM <br /> BUSINESS AUTO COVERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM <br /> With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br /> modified by this endorsement. <br /> B This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability <br /> z Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter <br /> coverage provided in the Coverage Form. <br /> This endorsement changes the policy effective on the inception date of the policy unless another date is <br /> indicated below. <br /> 0 <br /> r~ <br /> Named Insured: CLUBE±SSENTIAL HOLDINGS LLC <br /> M <br /> Endorsement Effective Date:11/15/2021 <br /> 0 <br /> M <br /> O <br /> N 'iS ' 3. II' �, 1 I- 0110 <br /> � 3 <br /> fk' €. <br /> OO <br /> d 11 <br /> Name Of Person(s) Or Organizationl's); <br /> 0 <br /> N <br /> ANY PERSON OR ORGANIZATION THAT THE NAMED INSURED IS OBLIGATED TO PROVIDE INSURANCE <br /> WHERE REQUIRED BY A WRITTEN CONTRACT OR AGREEMENT 1S AN INSURED,BUT ONLY WITH RESPECT <br /> TO LEGAL RESPONSIBILITY FOR ACTS OR OMISSIONS OF A PERSON/ORGANIZATION FOR WHOM <br /> LIABILITY COVERAGE IS AFFORDED UNDER THIS POLICY. <br /> information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but <br /> only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision <br /> contained in Paragraph A.1. of Section II - Covered Autos Liability Coverage in the Business Auto and Motor <br /> Carrier Coverage Forms and Paragraph D,2, of Section I - Covered Autos Coveragesof the Auto Dealers <br /> Coverage Form. <br /> Form No:CA 20 48 10 13 Policy No: 6079684568 <br /> Endorsement Effective Date: 11/15/2021 Endorsement Expiration Date: 11/15/2022 Policy Effective Date: 11/15/2021 <br /> Endorsement No: 26; Page: 1 or i <br /> Underwriting Company: Valley Forge Insurance Company <br /> copyright Insurance Services Office, Inc.,2011 <br />