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THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY <br />AGAINST OTHERS TO US <br />This endorsement modifies insurance provided under the following: <br />COMMERCIAL AUTOMOBILE COVERAGE PART <br />SCHEDULE <br />Name Of Person Or Organization: <br />Person(s) or Organization(a) as required by written contract when such written <br />contract is executed prior to an accident to which this endorsement applies. <br />Any individually scheduled Waivers shall not be construed to override nor negate <br />this blanket Waiver. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />CHANGE <br />We waive any right of recovery we may have against the person or organization shown in the Schedule above <br />because of payments we make for "bodily injury" or "property damage" to which this insurance applies, caused by <br />an "accident" and resulting from the ownership, maintenance or use of a covered "auto". This waiver applies only <br />to the person or organization shown in the Schedule above. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective 01/01/2022 Policy No. CA 6675880 Endorsement No. <br />Named Insured KAISER FOUNDATION HEALTH PLAN, INC. Premium $ Included <br />Insurance Company Safety National Casualty Corporation <br />«,Y RI MONganvdDhidan <br />Countersigned By i� �REMI &APPRovmi r. <br />Risk Management Specialist <br />SNCA 027 10 13 Safety National Casualty Corporation Page 1 of 1 <br />