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POLICY NUMBER:COMMERCIAL AUTO <br />CA 20 48 10 13 <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: <br />Endorsement Effective Date: <br />SCHEDULE <br />Name Of Person(s) Or Organization(s): <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 />CPA 0042875 14 <br />BROWN BROTHERS PLUMBING <br />& HEATING CO INC <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 />Docusign Envelope ID: 3CC33832-C157-4833-A3CC-68DABF46CA95