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POLICYNUMBER: (25) 7499-25-98 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 /> CITY OF SANTA ANA, ITS CITY COUNCIL, OFFICERS, OFFICIALS, <br /> EMPLOYEES, AGENTS, AND VOLUNTEERS <br /> ATTENTION: CITY ATTORNEY' S OFFICE <br /> 20 CIVIC CENTER PLAZA, M-29 <br /> SANTA ANA CA 92701 USA <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 <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 />