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A�A INSURED: Proactive Consulting Group, LLC <br />POLICY NUMBER: 4024152345 <br />EXPIRATION DATE: 6/1/2020 <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />This endorsement changes the policy to which it is attached. <br />It is agreed that Part One— Workers' Compensation Insurance G. Recovery From Others <br />and Part Two — Employers' Liability Insurance H. Recovery From Others are amended by <br />adding the following: <br />We will not enforce our right to recover against persons or organizations. (This agreement <br />applies only to the extent that you perform work under a written contract that requires you to <br />obtain this agreement from us.) <br />Premium Charge - 5% of the total standard premium for California exposure. <br />REVIEWED & APPROVES <br />By Risk M.4NgoFWAT '�ivisiON <br />�ALI% MO Aft <br />