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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 />City of Santa Ana <br />Risk Management Division <br />20 Civic Center Plaza <br />Santa Ana, CA 92702 <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 07/15/2021 Policy No. TWC4004913 Endorsement No. 001 <br />Insured Charitable Ventures of Orange County Endorsement Premium <br />Insurance Company Technology Insurance Company Countersigned <br />WC 00 03 13 <br />(Ed. 4-84) <br />l , IhNlYrID6AarPwIDBY:.. <br />7olt �%icxaa[ <br />-' Risk Maru9er�me[ImrulNAe <br />