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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 />Where required by written agreement signed prior to loss. <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 12-31-2023 <br />Insured Kimco Staffing Services, Inc. <br />Insurance Company <br />XL Insurance America, Inc. <br />WC 00 03 13 <br />(Ed. 4-84) <br />Policy No. RWD300121607 <br />Countersigned by <br />Endorsement No. <br />RAManagmumtDMsian <br />% x REVIEWED & APPROVED BY. <br />°�,1 aifl �d• l'.` As.�:e {icevedo <br />® <br />Risk Management Specialist <br />© 1983 National Council on Compensation Insurance. <br />