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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 37 <br /> (Ed. 5-02) <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA <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 /> You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the <br /> work described in the schedule. <br /> The additional premium for this endorsement shall be 5 %of the California Workers' Compensation premium <br /> otherwise due on such remuneration, subject to a minimum premium of $ 50. <br /> Schedule <br /> Person or Organization Job Description <br /> CITY OF SANTA ANA REQUIRED BY CONTRACT <br /> 801 W. CIVIC CENTER DR. , STE. <br /> 200 <br /> SANTA ANA, CA 92701 <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 08/23/2025 Policy No. WSD 5086075 00 Endorsement No. 001 <br /> Insured BROWNSON TECHNICAL SCHOOL INC Premium $ INCL. <br /> Insurance Company INSURANCE COMPANY OF THE WEST <br /> Countersigned By <br /> WC 99 06 37 <br /> (Ed. 5-02) <br /> INSURED <br />