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POLICY NUMBER: 810-526D7537 <br />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 <br />WHO <br />IS AN INSURED <br />provision <br />1. No liability is assumed by that <br />includes the person <br />or <br />organization <br />indicated <br />person or organization for the <br />below, but only for <br />his, <br />her or its <br />liability <br />payment of any premiums stated <br />because of acts or <br />omi <br />ssions of an <br />"insured" <br />in the policy or earned under <br />under paragraphs a. <br />or <br />b. of that provision, <br />the policy. <br />subject to the following <br />additional provisions: <br />Person or Organization <br />City of Eugene, its Officers and <br />Employees, The State of Oregon, Oregon <br />Transportation Commission and its members <br />and Department of Transportation, its <br />Officers and Employees <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 />Address <br />99 East Broadway Suite 400 <br />Eugene OR 97401 <br />CA T3 01 02 99 Page 1 of 1 <br />