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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br />(Ed. 4-84) <br />POLICYNUMBER: 2024011559442A <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 <br />enforce our right against the person or organization named in the Schedule. (This agreement applies only to <br />the extent that 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 />AS REQUIRED BY WRITTEN CONTRACT <br />DATE OF ISSUE: 0 8 / 05 / 2 4 <br />WC 00 03 13 <br />(Ed. 4-84) <br />m 1983 National Council on Compensation Insurance. <br />Schedule <br />APPROVED <br />By Cynthia Mora at 10:07 am, Dec 10, 2024 <br />INSURED COPY <br />