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Business Auto Policy <br />Policy Endorsement <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY <br />AGAINST OTHERS TO US (WAIVER OF SUBROGATION) <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 />This endorsement changes the policy effective on the inception date of the policy unless another date is <br />indicated below. <br />Named Insured: PAVE AMERICA, LLC <br />Endorsement Effective Date: 03/01/2023 <br />SCHEDULE <br />Name(s) Of Person(s) Or Organization(s): <br />ANY PERSON OR ORGANIZATION FOR WHOM OR WHICH YOU ARE REQUIRED BY WRITTEN CONTRACT <br />OR AGREEMENT TO OBTAIN THIS WAIVER FROM US. YOU MUST AGREE TO THAT REQUIREMENT PRIOR <br />TO 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 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 />BUA 7018235087 <br />Endorsement No: 12; Page: 1 of 1 Policy Page: 20 of 114 <br />Underwriting Company: Transportation Insurance Company, 151 N Franklin St, Chicago, IL 60606 <br />Form No: CA 04 44 10 13 <br />Endorsement Effective Date: <br />Policy No: <br />Policy Effective Date: 03/01/2023Endorsement Expiration Date: <br />© Copyright Insurance Services Office, Inc., 2011 <br />DocuSign Envelope ID: 797C32F6-C1CE-44EB-BF17-813A5939396C