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ADDITIONAL INSURED— <br /> DESIGNATED PERSONS OR ORGANIZATIONS <br /> Named Insured T Bailey Inc. Endorsement Number <br /> Policy Symbol Policy Number Policy Period Effective Date of Endorsement <br /> CAL H08450171-009 09/01/2017 to 09/01/2018 09/01/2017 <br /> Issued By(Name of Insurance Company) <br /> ACE American Insurance Company <br /> Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> This endorsement modifies insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> AUTO DEALERS COVERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM <br /> EXCESS BUSINESS AUTO COVERAGE FORM <br /> EXCESS TRUCKERS COVERAGE FORM <br /> Additional Insured(s): As required by written contract <br /> A. For a covered "auto,"Who Is Insured is amended to include as an"insured,"the persons or organizations named in <br /> this endorsement. However, these persons or organizations are an "insured" only for "bodily injury" or "property <br /> damage"resulting from acts or omissions of: <br /> 1. You. <br /> 2. Any of your"employees"or agents. <br /> 3. Any person operating a covered"auto"with permission from you, any of your"employees"or agents. <br /> B. The persons or organizations named in this endorsement are not liable for payment of your premium. <br /> Authorized Representative <br /> DA-9U74b(06/14) Page 1 of 1 <br /> 065 <br />