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POLICY NUMBER: BAP2018652-12 <br />COMMERCIAL AUTO <br />CA 04 44 10 13 <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: Ocean Blue Environmental Services, Inc. <br />Endorsement Effective Date: n7rn1/gn1A <br />SCHEDULE <br />Names) Of Persons) Or Organization(s): <br />Any Principal wherein such waiver has been included before loss as part of a contractual undertaking by the <br />Named Insured <br />�. _._..__.__...__......._...._.................................__......._...................._.............................._....._......._.............._..._..------..._-.__.— ------..._....___._._......._� <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 Others To Us condition does not apply to the person(s) or <br />organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or <br />the 'loss" under a contract with that person or organization. <br />CA 04 4410 13 © Insurance Services Office, Inc.,2011 Page 1 of 1 <br />RImViEWEt? BY EIItJIGE NERI�DIA PG OF I �. }. <br />