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11 <br /> POLICY t1ht9E 7352-29-55 0061MERCIALA42 TO <br /> CA2g 48021S <br /> THIS ENDORSEMENT CHANt;FS THE PCSLICY. PLEASE iwArs + AREFULL?. <br /> ' DESIGNATED INSURED �. <br /> Thin endorsement modifies IrrsursnceproAded under the fpllo rrgt <br /> BUSINES$AUTO COVERAGE FORM <br /> ti, RAGE edtrEPAC4E FORM <br /> bl Tr7R CAPRI ER COVERAGE FORM <br /> TRUCKERS COVERAGE PORTA <br /> • <br /> tlJlth rasped CO coverage provided by this endorsement,the provisions of the Coveraos Perrn apply wets modi-FI by <br /> this endorsement. <br /> This e+7dc servant identifiat pereon(s}or tl an(s)sxfio arsurmieumzlerthoVe'no 14 fiat Insured previa/ort of <br /> the Cocaraga3 Form.Th ra endorsaarrtartf[toes not atrac coverage provided!n thi Creveasa Farm <br /> This endorsement changers the policy effective on the Inception data of the policy uakwn another date i.R indroetcd <br /> below. <br /> Enderset'nont Etfaativa; 6/25/11 Ocuntar [vrl ay; _ <br /> . named rnsurad:ICF JONES&STOKES,INC. <br /> e^� I <br /> Js rizsd -.t€sontalive <br /> X1-1EtItittE <br /> Hama of Pereen(14 or Crgetizefbca{s); <br /> "Any person or organization as required by an insured contract' <br /> The City of Everett,its officers,employees and agents <br /> • <br /> (It no silty appears ab4Ve. lefermatlrtn required to complete!his ensorsernent will be shown in kite Daciera eros as <br /> eppr(aritr la Ga the endorseirter t) <br /> Each person or atrgattrzalIon shown in he Schedule is an Insr:red"for f"ahIIitp Cows-ago,taut only;a tltci,&xaen#thele <br /> person at orgmfzetioa gttallnea es art"If 9urwi"under the Woe la An Insured Provision contained in Soden ii at the <br /> covar®rge Form, <br /> GA 24 41) 99 Copyrtsht<I;+sur2.Roe£amines Oifica.Ino, tssa Pang.1 all t3 <br /> 85 <br />