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POLICY NUMBER: PHPK1.976777 <br />COMMERCIAL AUTO <br />CA 04 44 03 10 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, <br />This endorsement modifies Insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />BUSINESS AUTO PHYSICAL DAMAGE 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 modi- <br />fied 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: Mercy House Living Centers, Inc �! <br />Endorsement Effective Date: 05/02/2019 <br />FaP7:( 9111ft <br />Name(s) Of Person(s) Or Organization(s): <br />As Required by written contract <br />The Transfer Of Rights Of Recovery Against Oth- <br />ers To Us Condition does not apply to the person(s) <br />or organization(s) shown in the Schedule, but only to <br />the extent that subrogation is waited prior to the "ac- <br />cident' or the "loss" under a contract with that person <br />or organization. <br />CA 04 44 03 10 K) Insurance Services Office, Inc 2009 <br />Page 1 of 2 0 <br />