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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 <br />(Ed. 4-84) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. Wewill not enforce <br />our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br />perform work under a written contract that requires you to obtain this agreement from us.) <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />Where required by written contract <br />This endorsement changes the policy to which It is attached and Is effective on the date Issued unless otherwise stated. <br />(The Information below Is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Policy Effective 06/30/2017 <br />Endorsement Effective 06/30/2017 Polley No. WD001486 Endorsement No. <br />Insured PERSONNEL STAFFING GROUP, LLC DBA KBS STAFFING Premium $ <br />Insurance Company Protective Insurance Company Countersigned By <br />we 00 03 13 <br />(Ed. 4-64) <br />Copyright 1083 Notional Caunoll on Compensation Insuranso <br />