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POLICY NUMBER: 2024-49231 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: <br />Endorsement Effective Date: <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />Any person or organization with whom you have a written contract currently in effect or becoming effective <br />during the term of this policy. <br />Information required to <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 />RleleMns�.mtadDMebn <br />`�,9 REMEwED 6 APPROVED BV: <br />. A ALF1/ep-0 <br />�'•. <br />R¢k Management Spetlkist <br />CA 0444 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />