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7/31 /2024 <br />POLICY NUMBER: BAP557108812 COMMERCIAL AUTO <br />CA04441013 <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: All American Asphalt <br />Endorsement Effective Date: 08/01/2024 <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 />SCHEDULE: <br />City of Santa Ana <br />Risk Management Division <br />RFMEWED&APPROV®$Y: <br />Risk Management5pedAM <br />CA04441013 <br />c0 Insurance Services Office, Inc., 2011 <br />91239842 124 t01� Standard wish 53mm KS I Michael Mendoza 1 7/31121124 11 :1661 AM (PDT) I Page 10 of I I <br />