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Miscellaneous Attachment: M451784 Certificate ID: 21195691 <br /> TRAVELERS <br /> ONE TOWER SQUARE WORKERS COMPENSATION <br /> HARTFORD CT 06183 AND <br /> EMPLOYERS LIABILITY POLICY <br /> ENDORSEMENT WC 00 03 13 (00) - 016 <br /> POLICY NUMBER: UB-1T88663A <br /> UB-lT885681 <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br /> ENDORSEMENT <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy. <br /> We will not enforce our right against the person or organization named in the Schedule. (This <br /> agreement applies only to the extent that you perform work under a written contract that requires <br /> you to obtain this agreement from us.) <br /> This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. <br /> SCHEDULE <br /> DESIGNATED PERSON: <br /> DESIGNATED ORGANIZATION: <br /> ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED <br /> BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS <br /> WAIVER. <br /> INCLUDING: <br /> ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS AGREED <br /> BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO FURNISH THIS <br /> WAIVER. <br /> Any person or organization for which the employer has agreed by written <br /> contract, executed prior to loss, may execute a waiver of subrogation. <br /> However, for purposes of work performed by the employer in Missouri, this <br /> waiver of subrogation does not apply to any construction group of <br /> classifications as designated by the waiver of right to recover from others <br /> (subrogation) rule in our manual. <br /> ST ASSIGN: PAGE 1 OF1 <br />