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4 <br /> POLICY NUMBER: 57 UEN AM2726 COMMERCIAL.AUTO <br /> CA20010306 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> LESSOR - ADDITIONAL INSURED AND LOSS PAYEE <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> BUSINESS AUTO PHYSICAL DAMAGE 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 changes the policy effective on the inception date of the policy unless another date is indicated <br /> below. <br /> Named Insured: KRAZAN & ASSOCIATES, INC. <br /> Endorsement Effective Date: 10/01113 <br /> Countersignature Of Authorized Representative <br /> • Name: •Title: <br /> Signature: <br /> Signature: - - <br /> Date: - <br /> • <br /> • <br /> • <br /> • <br /> CA 20 0103 06 ©ISO Properties, Inc.,2005 Page 1 of 3 <br /> • <br /> 63 <br />