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DocuSign Envelope 10: FC7E9346-8A22-4923-BD05-AA3CA0439841 <br />Attachment Code: D574651 Certificate ID: 16765248 <br />POLICY NUMBER: BAP0146329 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: DUDEK <br />Endorsement Effective Date: 8/28/2022 <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION YOU ARE REQUIRED TO WAIVE YOUR RIGHTS <br />OF RECOVERY IN A WRITTEN CONTRACT, AGREEMENT OR PERMIT WITH THE <br />NAMED INSURED. <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 that <br />person or organization. <br />CA 04 44 10 13 Q Insurance Services Office, Inc., 2011 Page 1 of 1 <br />