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POLICY NUMBER: PHPK2127804 COMMERCIAL AUTO <br />CA 04 44 03 10 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY <br />AGAINST OTHERS TO US (WAIVER OF SUBROGATION) <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: 05/02/2020 7 <br />SCHEDULE <br />Namo(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 waived prior to the "ac- <br />cident" or the 'loss" under a contract with that person <br />or organization. <br />REVIEWED & APPROVED <br />By Risk MANACENIENT DIVISipN <br />JU 8 2020 <br />ANGie AGE cdo <br />CA 04 44 03 10 0 Insurance Services Office, Inc., 2009 Page 1 of 3 0 <br />