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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 43 0: <br />(Ed. 7-uu) <br />UTAH WAIVER OF SUBROGATION ENDORSEMENT <br />This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information <br />Page. <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br />right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform <br />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. Our waiver of rights does <br />not release your employees' rights against third parties and does not release our authority as trustee of claims against third <br />parties. <br />Schedule <br />1. Waiver Type Blanket <br />Any person or organization for whom the named insured has agreed by written contract to <br />furnish this waiver. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />Endorsement Effective 10/28/2024 Policy No. 4101201 Endorsement No. <br />Insured AlterTech Solutions LLC Premium <br />6185 S Mount Vernon Dr <br />Salt Lake City, UT 84107 <br />Insurance Company WCF Mutual Insurance Company <br />Countersigned by <br />WC 43 03 05 <br />(Ed. 7-00) <br />APPROVED <br />By Cynthia Mora at 12:28 pm, Nov 14, 2024 <br />0 Copyright 2WO National Council on Compensation Insurance. Inc All Rights Reserved. <br />