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POLICY NUMBER: 810-526D7537 COMMERCIAL. AUTO <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> ADDITIONAL INSURED <br /> This endorsement modifies insurance provided under the following: <br /> .BUSINESS AUTO ,.COVERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM. <br /> TRUCKERS COVERAGE FORM <br /> Paragraph c. of the WHO IS AN INSURED provision 1. No liability is assumed by that <br /> includes the person or organization indicated person or organization for the <br /> below, but only for his, her or its liability- payment of any premiums stated <br /> because of acts or omissions of an "insured" in the policy or .earned under <br /> under paragraphs a. or b. of that provision, the policy. <br /> subject to the following additional provisions: <br /> 2. In the event of cancellation of <br /> the, policy, written notice of <br /> cancellation will be mailed by <br /> us to that person or organiza- <br /> tion. <br /> Person or Organization Address <br /> City of Eugene 99 East Broadway Suite 400 <br /> Eugene OR 97401 <br /> <br /> CA T3 01 02 99 Page 1 of 1 <br /> <br />