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TRAVELERS J� WORKERS COMPENSATION <br /> AND <br /> ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY <br /> HARTFORD CT 06183 <br /> ENDORSEMENT WC 04 03 06 (01) — 007 <br /> POLICY NUMBER: UB-4X180519-26-42-G <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br /> ENDORSEMENT-CALIFORNIA <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 the <br /> extent that you perform work under a written contract that requires you to obtain this agreement from us.) <br /> You must maintain payroll records accurately segregating the remuneration of your employees while engaged in <br /> the work described in the Schedule. <br /> THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 5.00% OF THE CALIFORNIA WORKERS' <br /> COMPENSATION PREMIUM OTHERWISE DUE ON SUCH REMUNERATION. <br /> SCHEDULE <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> THE CITY OF SANTA ANA, ITS OFFICERS, AND EMPLOYEES VIDEO <br /> PRODUCTION <br /> DATE OF ISSUE: 02-18-26 ST ASSIGN: Page 1 of 1 <br />