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BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br />date is indicated below. <br />(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). <br />This endorsement, effective 07/01/2025 12:01 AM forms a part of Policy No. WC 063529822 CA <br />Issued to ADP TotalSource FL XVI, Inc. <br />5800 Windward Parkway <br />AI haretta, GA 30005 <br />L/�/F: <br />Elite Automotive Services LLC <br />26801 Vista Terrace <br />LakeForest, CA 92630 <br />By AIU Insurance Company <br />We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against any person or organization with whom you have a written contract that requires you to obtain this <br />agreement from us, as regards any work you perform for such person or organization. <br />The additional premium for this endorsement shall be _% of the total estimated workers compensation premium for <br />this policy. <br />ANY PERSON OR ORGANIZATION TO WHOM YOU BECOME OBLIGATED TO WAIVE YOUR RIGHTS OF <br />RECOVERY AGAINST, UNDER ANY CONTRACT OR AGREEMENT YOU ENTER INTO PRIOR TO THE <br />OCCURRENCE OF LOSS <br />WC 04 03 61 Countersigned by <br />(Ed.11/90) AuthorizeV Representative <br />