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Named Insured: <br />Endorsement Effective Date: <br />Name(s) Of Person(s) Or Organization(s): <br />POLICY NUMBER: COMMERCIAL AUTO <br />CA 04 44 10 13 <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 <br />indicated below. <br />SCHEDULE <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 <br />Others To Us condition does not apply to the <br />person(s)or organization(s)shown in the Schedule, <br />but only to the extent that subrogation is waived <br />prior to the "accident"or the "loss"under a contract <br />with that person or organization. <br />© Insurance Services Office, Inc., 2011 Page 1 of 1CA 04 44 10 13 <br />04/02/2024A0080216 <br />Middlesex Insurance Company <br />00001 0000000000 24093 0 N1 b013d1a2-43e3-4b50-9873-5f564bd65226b013d1a2-43e3-4b50-9873-5f564bd65226 <br />Docusign Envelope ID: CF064D56-F89A-8651-8229-D168AFF8B909