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POLICY NUMBER: A0253953001 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 <br /> indicated below. <br /> Named Insured: Southern Calitornia Precision Concrete, Inc. a: Precision Concrete Cutting <br /> Endorsement Effective Date: 6/2/2025 <br /> SCHEDULE <br /> Name(s)Of Person(s)Or Organization(s): <br /> As required per Written Agreement or Contract <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 <br /> prior to the "accident" or the "loss" under a contract <br /> with that person or organization. <br /> CA 04 44 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 <br /> A0253953 05/31/2024 <br /> Middlesex Insurance Company <br /> 1 00001 0000000000 24152 0 N ac7e1241-6M-47c4-88sd-80ccd262da26 <br />