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POLICY NUMBER: APJA000523-01 COMMERCIAL AUTO <br />CA 20 01 11 20 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />LESSOR - ADDITIONAL INSURED AND LOSS PAYEE <br />This endorsement modifies insurance provided under the following: <br />AUTO DEALERS COVERAGE FORM <br />BUSINESS AUTO COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless <br />modified by the endorsement. <br />This endorsement changes the Policy effective on the inception date of the Policy unless another date is indicated <br />below. <br />Named Insured: Fire Agencies Insurance Risk Authority (FAIRA) <br />Endorsement Effective Date: 7/1/2023 <br />SCHEDULE <br />Insurance Company: JPRIMA-Midvale <br />Policy Number: APJA000523-01 <br />Effective Date: 7/1/2023 <br />Expiration Date: 7/1/2024 <br />Named Insured: Fire Agencies Insurance Risk Authority (FAIRA) <br />Address: 1255 Battery Street, Suite 450 <br />San Francisco, CA 94111 <br />Additional Insured (Lessor): On File with Issuer <br />Address: On File with Underwriter <br />Designation Or Description Of "Leased Autos": See Schedule on File with Issuer <br />CA 20 01 11 20 © Insurance Services Office, Inc., 2019 Page 1 of 2 <br />