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POLICY NUMBER: ISA H08413216 COMMERCIAL AUTO <br />CA 24484299 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />DESfGNATED 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 <br />Form apply unless modified by this endorsement. <br />This endorsement identifies person{s) or organization(s) who are "insureds" under the <br />Who Is An Insured Provision of the Coverage Form. This endorsement does not alter <br />coverage provided in the Goverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless <br />another date is indicated below. <br />Endorsement Effective: Countersigned By: <br />4/1/10 <br />Named Insured: J~ ,~~~ ~iQ~~iUI~ICriII+G~ <br />ValleyCrest Tree Care (Authorized Representative) <br />Services <br />SCHEDULE <br />--- __ <br />Name of Person(s) or Organization(s): <br />City of San Leandro and its officers, officials, employees and volunteers <br />#492700881 -The City of San Leandro Bid #09-10.025 Various Locations, San Leandro, <br />CA. <br />(lf na entry appears above, information required to complete this endorsement will be <br />shown in the Declarations as applicable to the endorsement.) <br />Each person or organization shown in the Schedule is an "insuredA for Liability <br />Coverage, but only to the extent that person or organization qualifies as an "insured" <br />under the Who Is An insured Provision contained in Sec#lon ti of the Coverage Form. <br />CA 24 48 42 99 Copyright, Insurance Services Office, Inc., 1998 page 1 of 1 D <br />