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POLICY NUMBER: 71778180 05/15/2022/23 <br />Workers Compensation <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF TRANSFER OF RIGHTS OF RECOVERY <br />AGAINST OTHERS TO US <br />This endorsement modifies insurance provided under the following: <br />BUSINESSOWNERS COVERAGE FORM <br />SCHEDULE <br />Name <br />City of Santa Ana, CA. <br />Paragraph K. Transfer Of Rights Of Recovery <br />Against Others To Us in Section III = Common <br />Policy Conditions is amended by the addition of the <br />following: <br />We waive any right of recovery we may have against <br />the person or organization shown in the Schedule <br />above because of payments we make for injury or <br />damage arising out of your ongoing operations or <br />"your work" done under a contract with that person or <br />organization and included in the "products -completed <br />operations hazard". This waiver applies only to the <br />person or organization shown in the Schedule above. <br />SP 04 97 0106 ® ISO Properties, Inc., 2004 <br />_ RWkM w9a=tDMs[m <br />REVIEWED&APPROV®BY: <br />® R6k Management Specinlist <br />