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POLICY NUMBER: PHPKI976777 <br />ME IN I WOF <br />Ed"113 1014,319#1 RIM IMC Nall;] N00 <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 />Name(s) Of Percents) Or Organization(s): <br />As Required by written contract <br />The Transfer Of Rights Of Recovery Against Oth- <br />ers To Us Condition does riot apply to the person(s) <br />or organization(s) shown in the Schedule, but only to <br />the extent that subrogation is waived prior to the "ac- <br />cident" or the "loss" under a contract with that person <br />or organization. <br />CA04440310 V Insurance Services Office, Inc., 2009 Page 1 of 2 Cl <br />