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• <br /> 9 CHANIGE NO. 00 <br /> CPP 0004696 00 <br /> POLICY NUMBER: <br /> COMMERC�ALAUTO <br /> GA2 48 02 99 <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> DESIGNATED INSURED <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 modi- <br /> fied by this endorsement )I <br /> This endorsement identifies person(s) or organization(s) who are "insureds"under the Who Is 41n Insured Provi- <br /> sion of the Coverage Form.This endorsement does not alter coverage provided in the Coverage Fo I. <br /> This endorsement changes the policy effective on the inception date of the policy unless another date is indi- <br /> cated below. <br /> Endorsement Effective: 04/18/2011 Countersigned By: <br /> Named Insured: <br /> MARK HITCHCOCK (Authoriz Representative) <br /> SCHEDULE <br /> Name of Person(s)or Organization(s): <br /> CITY OF EVERETT <br /> ATTN: JAMES W KILLER • <br /> 3200 CEDAR ST <br /> EVERETT WA 98201 <br /> (If no entry appears above, information required to complete this endorsement will be shown in the Declarations <br /> as applicable to the 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 <br /> in Section 11 of the Coverage Form. <br /> • <br /> CA 20 48 02 99 Copyright,Insurance Services Office, Inc., 1998 age I of I 0 <br /> 62 <br />