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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 <br />m <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT • BLANKET <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 />The additional prentium for this endorsement shall be <br />otherwise due. <br />Person or Organization <br />ANY PERSON / ORG <br />WHEN REQUIRED BY <br />WRITTEN CONTRACT <br />3 % of the total California Workers' Compensation prerrium <br />Schedule <br />Job Description <br />ALL CA OPERATIONS <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 poky.) <br />Endorsement Effective 06/03/2022 PolicyNo.WVE 5030354 07 Endorsement No. <br />Insured CROSSTOWN ELECTRICAL & DATA 1 Prerrium $ INCL. <br />Insurance Company INSURANCE COMPANY OF THE WEST I" I <br />WC 99 D6 34 <br />(Ed. 8-00) <br />Countersigneb By f w <br />f <br />INSURED <br />RlekMvugeme tD[winn <br />REVIEI D&APPRDV®BY: <br />A, J AM4 <br />now <br />Risk Management Spenah,t <br />