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CNA <br />WAIVER, OF TRANSFER OF RIGHTS OF RECOVERY <br />AGAINSTOTHERSTO US (WAIVER OF SUBROGATIONI <br />Business Auto Policy <br />Policy Endorsement <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: IEC CORPORATION <br />Endorsement Effective Date: 07131 /2022 <br />,• ):,,-tyr"F" <br />® ® z :n2 $z .,byj„,r 5'iml a#YES r• A-sd n` k'f�,4 S S .+ j e e ��,..... 1+',aa2,.. „� <br />*cam EN"' <br />pe <br />i <br />r 9 <br />�'NcArsr�r <br />ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT <br />OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR <br />• LOSS. <br />Information required to complete this Schedule,not • above,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 />Endorsement Effective Date: Endorsement Expiration Date: <br />Endorsement No: 4; Page: 1 of 1 <br />Underwriting Company: Valley Forge Insurance Company, 151 N Franklin St, Chicago, IL 60606 <br />Policy No:7015271690 <br />'Mug T,%60V)0C44t <br />® Copyright Insurance Services Office, Inc., 2011 Rak Manawi ,a&n ,i <br />