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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br />1st Reprint Effective April 1, 1984 Adviso <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <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 />Blanket Waiver — Any person or organization to whom you become obligated to waive your rights of recovery against, <br />Under any contract or agreement you enter into prior to the occurrence of loss. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Effective:05/10/2024 Policy No.: WC-WF-TS-0001923-02 Endorsement No.:0000 <br />Insured:Helpmates Staffing Services, LLC Premium: <br />Work First Casualty Company <br />Countersigned By <br />© 1983 National Council on Compensation Insurance. <br />