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POLICY NUMBER: 6057040575 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 modified by <br />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: 05/01/2020 <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION AGAINST WHOM j <br />YOU HAVE AGREED TO WAIVE SUCH RIGHT OF <br />RECOVERY IN A WRITTEN CONTRACT OR <br />AGREEMENT. <br />Information required to complete this Schedule, if not shown above, will be shown in the Declarations. <br />R The Transfer Of Rights Of Recovery Against Others <br />To Us Condition does not apply to the person(s) or <br />R 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 />REVIEWED & APPROVED <br />By Risk MANAGEMENT Division <br />APR 2 2020 <br />ANGiE AcEvEdo <br />CA 04 44 0310 Copyright, Insurance Services Office, Inc., 2009 Page 1 of 1 <br />