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CNABusiness Auto Policy <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <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 <br />indicated below. <br />Named Insured: WARE MALCOMB <br />Endorsement Effective Date: 06/2012021 <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN <br />CONTRACT OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT <br />I REQUIREMENT PRIOR TO LOSS. I <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 Others To Us condition does not apply to the person(s) or <br />organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" <br />or the "loss" under a contract with that person or organization. <br />Form No: CA 04 44 10 13 <br />0 Copyright Insurance Services Office, Inc., 2011 <br />P <br />P <br />r11 C1 AG1 <br />R®Ir Maugemmt DMdm <br />CCREV ewm SpAPPR.O/VVED BY. <br />®1 <br />- Ruk Managemen[Malyst <br />Of <br />