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DocuSign Envelope ID: E67DC299-98E1-4682-B281-3085AC9FC5B4 <br /> Business Auto Policy <br /> CNA Policy Endorsement <br /> M <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <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 /> R <br /> y This endorsement changes the policy effective on the inception date of the policy unless another date is <br /> z <br /> indicated below. <br /> Named Insured: CLUBESSENTIAL HOLDINGS LLC <br /> Endorsement Effective Date: 11/15/2021 <br /> M <br /> r~ <br /> IA <br /> s e0. P` r nri Orga;izat� ri `s 6 ro <br /> N -se .w - a. ��k E6 6& a. s <br /> ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT <br /> co <br /> OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR <br /> g TO LOSS. <br /> Q <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 To Us condition does not apply to the person(s) or <br /> organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" <br /> or the "loss" under a contract with that person or organization. <br /> Form No:CA 04 44 10 13 Policy No: 6079684568 <br /> Endorsement Effective Date 11/15/2021 Endorsement Expiration Date: 11/15/2022 Policy Effective Date: 11/15/2021 <br /> Endorsement No: 1; Page: 1 of 1 Policy Page: 35 of 58 <br /> Underwriting Company: Valley Forge Insurance Company <br /> ®Copyright Insurance Services Office, Inc.,2011 <br />