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Named Insured: Catholic Charities of Orange County <br />Policy Number: 10005295 <br />Corporate Id: WAIVER OF OUR RIGHT <br />TO RECOVER FROM OTHERS ENDORSEMENT <br />CALIFORNIA <br />We have the right to recover our payments from <br />anyone liable for an injury covered by this policy. <br />We will not enforce our right against the person or <br />organization named in the Schedule. (This <br />agreement applies only to the extent that you <br />perform work under a written contract that <br />requires you to obtain this agreement from us.) <br />You must maintain payroll records accurately <br />segregating the remuneration of your employees <br />Person or Organization <br />while engaged in the work described in the <br />Schedule. <br />The additional premium for this endorsement shall <br />be % of the California workers' <br />compensation premium otherwise due on such <br />remuneration. <br />Schedule <br />Job Description <br />City of Santa Ana, its officers, employees, agents and representatives <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <br />REVIEWED & APPROVED <br />By Risk MANAgFMENT iiiviSION <br />WC0403060484 <br />p <br />,�1- °.o-,....> Page 1 of 1 <br />FRANCINE R. VILLAREAL <br />