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SIMPLEX/GRINNELL, LP 10 - 2014
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SIMPLEX/GRINNELL, LP 10 - 2014
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Last modified
7/7/2016 5:34:49 PM
Creation date
1/27/2014 11:02:11 AM
Metadata
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Template:
Contracts
Company Name
SIMPLEX/GRINNELL, LP
Contract #
N-2014-006
Agency
POLICE
Expiration Date
10/31/2014
Insurance Exp Date
10/1/2014
Destruction Year
2019
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POLICY NUMBER: ISA H0872264A <br />Endorsement Number: 1 <br />COMMERCIAL AUTO <br />CA 04 44 0310 <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: Tyco International Management Company, LLC <br />Endorsement Effective Date: <br />SCHEDULE <br />Names Of Persons Or Organization(s): <br />Any person or organization against whom you have agreed to waive your right of recovery In a written contract, <br />provided such contract was executed prior to the date of loss. <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 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 />',',D AS T4 FORM <br />- °aur,, A. Rossini <br />" t.t, Attorney <br />CA 04 44 0310 0 Insurance Services Office, Inc., 2009 Page 1 of 1 13 <br />
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