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WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS <br /> Named Insured T Bailey Inc. Endorsement Number <br /> Policy Symbol Policy Number Policy Period Effective Date of Endorsement <br /> CAL H08450171-009 09/01/2017 TO 09/01/2018 09/01/2017 <br /> Issued By(Name of Insurance Company) <br /> ACE American Insurance Company <br /> Insert the policy number.The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of the policy. <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> This Endorsement modifies insurance provided under the following: <br /> BUSINESS AUTO COVERAGE FORM <br /> MOTOR CARRIERS COVERAGE FORM <br /> AUTO DEALERS COVERAGE FORM <br /> We waive any right of recovery we may have against the person or organization shown in the Schedule below because of <br /> payments we make for injury or damage arising out of the use of a covered auto. The waiver applies only to the person or <br /> organization shown in the SCHEDULE. <br /> SCHEDULE <br /> Any person or organization for whom you are required in a written contract or agreement,with such written contractor <br /> agreement signed prior to commencement of operations,to waive any right of recovery we may have against the person <br /> or organization, but only for"bodily injury"or"property damage"to which this insurance applies if the"accident"is caused <br /> by a)you, while using a covered "auto", or b)any other person, while using a covered "auto"with your permission. <br /> Authorized Representative- <br /> DA-13115a (06/14) Page 1 of 1 <br /> 062 <br />