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SENTRY INSURANCE A MUTUAL COMPANY <br />Carrier Code No. 15571 <br />WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />POLICY NUMBER: 90-14923-01 00 191 <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the right to recover our payments from anyone liable for <br />an injury covered by this policy. We will not enforce our right <br />against the person or organization named in the -Schedule. (This <br />agreement applies only to the extent that you perform work under <br />a written contract that requires you to obtain this agreement <br />from us.) <br />This agreement shall not operate directly or indirectly to benefit <br />any one not named in the Schedule. <br />Schedule <br />"ALL WRITTEN CONTRACTS PROVIDED SUCH CONTRACT WAS MADE PRIOR TO LOSS" <br />WC 00 03 13 (Ed. 04-84) <br />Copyright 1983 National Council on Compensation Insurance. <br />HOL 90-14923-01 00 191 <br />08-01-19 <br />PAGE 001 <br />HOLLAND & KNIGHT LLP <br />cF RiskMwaganedDMsian <br />REVIEWED & APPROVED BY: <br />V"° <br />--� Risk janagement Analyst <br />01T760RG <br />