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POLICY NUMBER: COMMERCIAL AUTO <br /> CA 20 01 10 13 <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 /> 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 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: <br /> Endorsement Effective Date: <br /> SCHEDULE <br /> Insurance Company: <br /> Policy Number: Effective Date: <br /> Expiration Date: <br /> Named Insured: <br /> Address: <br /> Additional Insured (Lessor): <br /> Address: <br /> Designation Or Description Of"Leased <br /> Autos": <br /> CA 20 01 10 13 Copyright, Insurance Services Office, Inc., 2011 Page 1 of 2 <br />