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Policy Number: TSRSCA000027800 COMMERCIAL AUTO <br />CA04441013 <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 />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 indicated <br />below. <br />Named Insured: <br />Endorsement Effective Date: <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ALL PERSONS OR ORGANIZATIONS AS PER REQUIRED BY WRITTEN CONTRACT <br />WITH THE NAMED INSURED. THE WRITTEN CONTRACT MUST BE SIGNED PRIOR <br />TO THE DATE OF THE "ACCIDENT". <br />I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I <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 <br />the extent that subrogation is waived prior to the <br />"accident' or the "loss" under a contract with that <br />person or organization. <br />CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 <br />INSURED COPY <br />