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BA25571088-03 <br />POLICY NUMBER COMERCIAL AUTO <br />CA 0444 0310 <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 modules Insurance provided under the following: <br />BUSINESS AUTO COVERAGE FORM <br />BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FOMA <br />VAh respect to coverage provided by this endorsement, the provisions or the Coverage Form appy unless modi- <br />(ied by the endorsement. <br />This endorsement changes the poky d kdiv®on the Ineptlon dale of the policy unless another date is Indicated <br />below. <br />Named lr xed: All Americana Asphalt <br />Endorsrnor EfpcUM OMIs. 8/1/15 <br />Nan*s) Of Parson(s) OrOrg nkelon(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 />The Transfer Of Rights Of Rsoonrey Againd Olhrs <br />To Us Condition does not appy to the person(s) or <br />orgrdzation(s) shown in the Schedule, but only to <br />the extent that subrogation Is waved prior to the'bc- <br />cidenP' or the loss" under a corked with that person <br />ororgarzatlon. Schedule <br />City of Santa Ana, its officers, employees, agents, volunteers <br />and representatives <br />Project <br />Project #15-6839 /RE: Local Street Slurry Seal 2014- <br />15 <br />3910 <br />CA 0444 0310 O Insurance Services Office, Inc., 2009 Page 1 d 1 0 <br />