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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 />This endorsement is not applicable in AK, KY, NH and NJ. <br />The waiver does not apply to any right to recover payments which the <br />Minnesota Workers Compensation Reinsurance Association may have or pursue <br />under M.S. 79.36. <br />Schedule <br />Any person or organization for which the employer has agreed by written contract, executed prior to loss, may <br />execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver <br />of subrogation does not apply to any construction group of classifications as designated by the waiver of right to <br />recover from others (subrogation) rule in our manual. <br />Where required by contract or written agreement prior to loss and allowed <br />by law. <br />In the states of AL, AZ, AR, CO, DE, DC, GA, ID, IL. IN, KS, ME, MI, MN, <br />MS, MO, MT, NV, NM, OK, PA, RI, SC, SD, VT and WV the premium charge is 0% <br />of the total manual premium subject to a minimum premium of $0 per policy. <br />In the states of CT, FL, IA, MD, NE and OR, the premium charge is 1 % of <br />the total manual premium, subject to a minimum premium of $250 per policy. <br />In the state of HI, the premium charge is $250 and determined as follows: <br />The premium charge for this endorsement is 1% of the total manual premium, <br />subject to a minimum premium of $2S0 per policy. <br />In the state of LA, the premium charge is 2% of the total standard <br />premium, subject to a minimum premium of $250 per policy. <br />In the state of MA, the premium charge is 1 % of the total manual premium. <br />In the state of NC, the premium charge is 2% of the total manual premium, <br />subject to a minimum premium of $100 per policy. <br />In the states of NY & TN, the premium charge is 2% of the total manual <br />premium, subject to a minimum premium of $250 per policy. <br />WC 00 03 13 ® 1983 National Council on Compensabon Insurance. <br />Ed. 04/01 /1984 <br />s < RhkMge v DWAm - <br />f2ncwmanrmadmBr <br />$' - %u DtcxaaK <br />Rxxnt„�y�,m„ummiade01 <br />61 <br />