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CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />POLICY NUMBER: AS2-661-067353-023 COMMERCIAL AUTO <br />CA 04 44 10 13 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY 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 modified <br />by the endorsement. <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />Any person or organization for whom you perform work under a written contract if the contract requires you to <br />obtain this agreement from us, but only if the contract is executed prior to the injury or damage occurring. <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 <br />To Us condition does not apply to the person(s) or <br />organization(s) shown in the Schedule, but only to the <br />extent that subrogation is waived prior to the "accident" <br />or the "loss" under a contract with that person or <br />organization. <br />Docusign Envelope ID: AE6D62F6-F8A3-4FE3-ABFB-CC69763A0B44