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POLICY NUMBER: PHPK2599195007 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: Kimco Staffing Services, Inc. <br /> Endorsement Effective Date: 09/01/2025 <br /> SCHEDULE <br /> Name(s) Of Person(s) Or Organ izat ion(s): <br /> Any person or organization who you are required to add by written contract which is executed prior to the <br /> occurrence of a loss to waive your rights of recovery, except for a loss resulting from the sole negligence from <br /> that person or organization. <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 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 /> CA 04 44 03 10 © Insurance Services Office, Inc., 2009 Page 1 of 1 <br />