Laserfiche WebLink
1/20/2021 <br />POLICY NUMBER: BAP55710e8-08 COMMERCIAL AUTO <br />CA 04 4410 13 <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 />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: All American Asphalt <br />Endorsement Effective Date: 08/01/2020 <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN <br />CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE <br />ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER <br />THIS POLICY <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />The Transfer Of Rights Of Recovery Against <br />Others To Us condition does not apply to the SCHEDULE: <br />person(s) or organization(s) shown in the Schedule, City of Santa Ana. <br />but only to the extent that subrogation is waived prior <br />to the "accident' or the "loss" under a contract with <br />that person or organization. <br />CA 04 44 10 13 © Insurance Services Office, Inc., 2011 <br />_ E RLAMmagemed D[Wabn <br />h� REmE&m&APPRWm8y: <br />low' Risk Management Malys[ <br />59791882120 [01[ Standard with $5mm XS I Seta Ilo I In6n021 4 14 08 PM (PST) I Pa,, 10 of I I <br />