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POLICYNUMBER: BAP 1857085-03 COMMERCIAL AUTO <br />CA 04 44 10 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: <br />Endorsement Effective Date: <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 <br />person(s) or organization(s) shown in the Schedule, <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 0444 10 13 © Insurance Services Office, Inc., 2011 <br />Ri�MwgaimlOnman S. <br />11�REVIE 6nPRRwm Br <br />%au Per , F <br />�Ruk Maixgemmcu iad <br />