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Attachment Code: D587563 Master TD: 1491 108, Certificate ID: 17506716 <br />POLICY NUMBER: 7014842659 <br />COMMERCIAL AUTO <br />CA 04 44 03 10 <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 />BUSINESS AUTO COVERAGE FORM <br />BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM <br />GARAGE COVERAGE FORM <br />MOTOR CARRIER COVERAGE FORM <br />TRUCKERS COVERAGE FORM <br />With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- <br />fied 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: NV5 Global, Inc <br />Endorsement Effective Date: 05/01/2021 <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE SUCH RIGHT OF <br />RECOVERY IN A WRITTEN CONTRACT OR AGREEMENT. <br />intormatlon reaulrea to complete tnls 5cneauie. It not snown above. will be snown In the ueclaratlons. <br />The Transfer Of Rights Of Recovery Against Oth- <br />ers To Us Condition does not apply to the person(s) <br />or organization(s) shown in the Schedule, but only to <br />the extent that subrogation is waived prior to the "ac- <br />cident' or the "loss" under a contract with that person <br />or organization. <br />CA 04 44 03 10 © Insurance Services Office, Inc., 2009 <br />cF RAManagementDMsian <br />Jy/\'x REVIEWED & APPROVED BY.- <br />V"° <br />--� Risk janagement Analyst <br />