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Buubdinfou!Dpef;!E698693!Nbtufs!JE;!25:2219-!Dfsujgjdbuf!JE;!28651:39 <br />Policy No. 7014842824 <br />Workers' CompensationWorkers' Compensation <br />I WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <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 contract that requires you to obtain this agreement from us.) <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />Any person or organization against whom you have agreed to waive such right <br />of recovery in a written contract or agreement <br />The premium charge for the endorsement is reflected in the Schedule of Operations. <br />All other terms and conditions of the policy remain 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 Effective date of said policy at the hour stated in said policy, unless another effective <br />date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy unless another <br />expiration date is shown below. <br />Form No: WC 00 03 13 (04-1984)Policy : 7014842824 <br />Endorsement Effective Date 05/01/2022 <br />Copyright 1983 National Council on Compensation Insurance. <br /> <br />