Orange County NC Website
Browse       Search
POLICY NUMBER: COMMERCIAL AUTO <br /> CA 20 48 Z 10 13 <br /> <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> <br /> West Bend Mutual Insurance Company <br />West Bend, Wisconsin 53095 <br />Contains material copyrighted by ISO, with its permission. <br />CA 20 48 Z 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br /> <br />DESIGNATED INSURED FOR <br />COVERED AUTOS LIABILITY COVERAGE <br /> <br />This endorsement modifies insurance provided under the following: <br /> <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br /> <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- <br />fied by this endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage <br />under the Who Is An Insured provision of 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 /> <br />Named Insured: <br />Endorsement Effective Date: <br /> <br />SCHEDULE <br /> <br />Name of Person(s) or Organization(s): <br /> <br /> <br /> <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br /> <br /> <br />A. Each person or organization shown in the Sched- <br />ule is an "insured" for Covered Autos Liability <br />Coverage, but only to the extent that person or or- <br />ganization qualifies as an "insured" under the Who <br />Is An Insured provision contained in Paragraph <br />A.1. of Section II – Covered Autos Liability Cover- <br />age in the Business Auto and Motor Carrier Cov- <br />erage Forms and Paragraph D.2. of Section I <br />Covered Autos Coverages of the Auto Dealers <br />Coverage Form. <br />B. The following is added to the Other Insurance <br />Condition in the Business Auto and Auto Dealers <br />Coverage Forms and the Other Insurance – Pri- <br />mary And Excess Insurance Provisions in the Mo- <br />tor Carrier Coverage Form and supersedes any <br />provision to the contrary: <br />This Coverage Form's Covered Autos Liability <br />Coverage is primary to and will not seek contribu- <br />tion from any other insurance available to an "in- <br />sured" shown in the schedule provided that: <br /> 1. Such "insured" is a Named Insured under such <br />other insurance; and <br /> 2. You have agreed in writing in a contract or <br />agreement that this insurance would be prima- <br />ry and would not seek contribution from any <br />other insurance available to such "insured". <br /> <br />B030828 <br />Intellicom Inc <br />04-01-2023 <br />Any party for whom the insured is required to provide designated insured status. <br />DocuSign Envelope ID: 211CC192-967F-4DF6-8BEB-5B75208BEEE3