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i <br /> i <br /> POLICY NUMBER: BAP204177e-11 COMMERCIAL AUTO i <br /> CA 04 44 1013 <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 /> i <br /> AUTO DEALERS COVERAGE FORM <br /> BUSINESS AUTO COVERAGE FORM <br /> MOTOR CARRIER COVERAGE FORM <br /> €r <br /> 1 <br /> t <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: <br /> Endorsement Effective elate: <br /> SCHEDULE <br /> i <br /> Names Of Person(s)Or Organlzation(s): i <br /> Any Principal wherein such waiver has been included before loss as part of a contractual undertaking by the <br /> Named Insured t <br /> Information required to complete this Schedule,if not shown above,will be shown In the Declarations. i <br /> i <br /> The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or <br /> organizallon(s) shown in the Schedule, but only to the extent that subrogatlon is waived prior to the "accident'or <br /> the"loss" under a contract with that person or organization. <br /> I <br /> s <br /> r <br /> i <br /> z <br /> a <br /> i <br /> {i <br /> 1 <br /> 7 <br /> `l <br /> f <br /> I <br /> I <br /> CA 04 44 10 13 ©Insurance Services Office,Inc„2011 Page 1 of 1 <br />