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CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 Page 1 of 1 o <br />POLICY NUMBER: AH3A42745814 COMMERCIAL AUTO <br />CA 20 48 02 99 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />DESIGNATED 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 Form apply unless modified by this <br />endorsement. <br />This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provision of the <br />Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. <br />This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. <br />Endorsement Effective: 09/24/2025 Countersigned By: <br />Named Insured: NBS GOVERNMENT FINANCE <br />(Authorized Representative) <br />SCHEDULE <br />Name of Person(s) or Organization(s): <br />ANY PERSON OR ORGANIZATION WHEN <br />REQUIRED BY A WRITTEN CONTRACT, <br />WRITTEN AGREEMENT OR PERMIT. <br />(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applica- <br />ble to the endorsement.) <br />Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person <br />or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage <br />Form. <br /> <br />Docusign Envelope ID: DF0F3531-C78A-8495-81AB-E9DA9043C7B4