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INSURED: InfoSend, Inc. <br />POLICY #: BBWVVK1000066300 <br />POLICY PERIOD: 02/01/2020 TO 02MI12021 <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 04 03 OS <br />(Ed. 4-14) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT —CALIFORNIA <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not <br />enforce our right against the person or organization named In the Schedule. (This agreement applies only to the <br />extent that you perform work under a written ccintract that requires you to obtain this agreement from us.) <br />You must maintain payroll records accurately, segregating the remuneration of your employees while engaged In <br />the work described in the Schedule. <br />The additional premium for this endorsement shell be _2_u/, of the California workers' compensation premium <br />otherwise due on such remuneration. <br />Schedule <br />Person or Organization Job Description <br />ANY PERSON OR ORGANIZATION WHEN SUCH <br />WAIVER IS REQUIRED BY A WRITTEN <br />CONTRACT THAT YOU HAVE AGREED TO <br />PRIOR TO LOSS <br />WC 04 03 06 <br />(Ed. 4-84) <br />This endoraemcre chansai the policy to which it N almehed eti'ectNe on the dote issued unkm othtiu-w MWd. <br />(The leraetnallon below h refrained only when this eadnnerwst is homed wbsequent to preparation elite policy.) <br />C'wmfersilmel by <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />J l N 1 2020 <br />AN,l ACEVEdc <br />