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} ' iLberty Mutual. COMMERCIAL AUTO <br /> " INSURANCE CA20480299 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> DESIGNATED INSURED <br /> POLICY NUMBER: 25-CC-3 61851-7 <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 <br /> modified by the endorsement. <br /> This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured <br /> provision 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 <br /> indicated below: <br /> Endorsement Effective: Countersigned By: <br /> 07-01-19 <br /> Named Insured: <br /> FORTERRA (Authorized Representative) <br /> SCHEDULE <br /> Name of Person(s)Or Organization(s): <br /> CITY OF EVERETT <br /> 802 E MUKILTEO BLVD EVERETT, WA 98203 <br /> (If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br /> or Schedule as applicable to this endorsement.) <br /> Each person or organization shown in the Schedule is an "insured"for Liability Coverage, but only to the extent <br /> that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section <br /> II of the Coverage Form. <br /> Copyright, Insurance Services Office, Inc., 1998 <br /> CA 20 48 02 99 EP <br /> AFP•M ETA2.03.PR INT001•D 140-J227J <br />