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Attachment Code: D587584 Master 1D: 1491108, Certificate ID: 17540928 <br />Policy No. 7014842810 <br />W due ini' i3 "„t1l t l�t�w,1r9U �fV� 1,� U1f� <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 and (Part Two -' <br />Employers' ILIa'blllity Insurance Ih'I. IRecovery From Others alre alrnen'ded by adding the following: <br />We will not 'enforce our night to recover against persons or organizations. (This agreement applies only to the <br />extent that you perform work rounder a written contract that requires you to obtain this agreement from us.) <br />PREMIUM CHARGE - Refer to the Schedule of Operations <br />The charge will be an amount to which you and we agree that is a percentage of the total standard premium for <br />California exposure, The amount is Blanket Waiver of Subrogation Percentage Charge , <br />All other terms and conditions of the policy Iremain unchanged. <br />This endorsement„ which forms a part of and 'is for attachment to the policy issued by the designated Insurers, <br />takes effect on the Policy Iffectiwre date of said policy at the hour stated in said policy, unless another <br />effective date (the IEndorsement IEffective IMDate) is shown Ibelow, and expires concurrently with said policy <br />unless another expiration date is shown Ibelow. <br />x+,kre <br />REVIEW EO & APPRovm By.. <br />139 K Management$upervesor <br />Forma No: - 19 1'00-I ICY 1-'1 7) POl <br />Endorsement Effective (Date; L05/01/2022 <br />