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DocuSign Envelope ID: DF078B63-CCED-42B9-8016-A67D8F6DF779 <br /> POLICY NUMBER: PCA 0006942 11 COMMERCIAL AUTO <br /> CA20481013 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> DESIGNATED INSURED FOR <br /> COVERED AUTOS LIABILITY COVERAGE <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 /> This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability <br /> 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 in- <br /> dicated below. <br /> Named Insured: BROWN BROTHERS PLUMBING <br /> & HEATING CO INC <br /> Endorsement Effective Date: <br /> SCHEDULE <br /> Name Of Person(s) Or Organization(s): <br /> ANY OR ALL PERSON(S) OR ORGANIZATION(S)AS REQUIRED BY <br /> WRITTEN/EXECUTED CONTRACT, FOR JOBS IN THE STATE OF <br /> NORTH CAROLINA <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 <br /> is an "insured" for Covered Autos Liability Cover- <br /> age, but only to the extent that person or <br /> organization qualifies as an "insured" under the <br /> Who Is An Insured provision contained in <br /> Paragraph A.1. of Section II — Covered Autos <br /> Liability Coverage in the Business Auto and Motor <br /> Carrier Coverage Forms and Paragraph D.2. of <br /> Section I — Covered Autos Coveragesof the Auto <br /> Dealers Coverage Form. <br /> CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />