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ENDORSEMENT AGREEMENT <br />WAIVER OF SUBROGATION <br />BLANKET BASIS <br />HOME OFFICE <br />SAN FRANCISCO EFFECTIVE, August 1, 2021 AT 12.01 A.M. <br />AND EXPIRING August 1, 2022 AT 12 . Ol A- M <br />ALL EFFECTIVE DATES ARE <br />AT 12:01 AM PACIFIC <br />STANDARD TIME OR THE <br />TIME INDICATED AT <br />PACIFIC STANDARD TIME <br />MIKE PRLICH & SONS INC. <br />5103 ELTON ST. <br />BALDWIN PARK, CA 91706 <br />NEW 9280970-21 <br />SP <br />PAGE 1 OF I <br />WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br />LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br />NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br />ORGANIZATION NAMED IN THE SCHEDULE. <br />THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br />PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br />TO OBTAIN THIS AGREEMENT FROM US. <br />THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE <br />2.00 OF THE TOTAL POLICY PREMIUM. <br />SCHEDULE <br />PERSON OR ORGANIZATION JOB DESCRIPTION <br />ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br />FOR WHOM THE NAMED INSURED SUBROGATION <br />HAS AGREED BY WRITTEN <br />CONTRACT TO FURNISH THIS <br />WAIVER <br />NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE <br />OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS <br />POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE <br />HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br />LIMITATIONS OF THIS ENDORSEMENT. <br />COUNTERSIGNED AND <br />r(((ISSUED AT SS]AANNFFRANCISCO: August 1, 20,21 <br />AUTHORIZED REPRESENT IVE PRESIDENT AND CE <br />SCIF FORM 10217 IREV-7-20141 <br />64000711 1 21/22 GL/AU/UMB/WC/POLL I Tina Kennedy 1 9/20/2021 1:59:50 PM (PDT) I Page 6 of 8 <br />This certificate cancels and supersedes ALL previously issued certificates. <br />,rN.ortaN�e 1[fakManggma,dDRRSLan <br />REVIEWED & APPROVED By. <br />>c A c R. M444a <br />Risk Management Analyst <br />