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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br />(Ed. 4-84) <br />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 enforce <br />our right against the person or organization named in the Schedule. (This agreement applies only to the extent that <br />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 that you have agreed with in a written contract to provide this agreement. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective 11/20/2020 <br />Insured <br />BOA ARCHITECTURE <br />Insurance Company <br />RLI Insurance Company <br />WC 00 03 13 <br />(Ed.4-84) <br />• 1983 National Council on Compensation Insurance. <br />Policy No. <br />PSW 0004454 <br />Countersigned by: <br />Endorsement No. <br />Premium $ <br />c` WekMnugernwtEDtvlefon <br />i REVIEV/ED & APPRW® By. <br />��yillll€1' facev.:n.e P.. V:usnta.� <br />�Zqwp. Risk Management Analyst - <br />