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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA <br />This endorsement changes the policy to which it is attached effective on inception date of the policy unless <br />a different date is indicated below. <br />(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation ofthe policy.) <br />This endorsement, effective 12:01 AM 07/01/10 forms apart of Policy No. 20 WN MF5434 A/o <br />Issued to: TRC Solutions, Inc. <br />$y: Twin City Fire Insurance Company <br />Premium: INCL <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will <br />not enforce our right against the person or organization named in the Schedule. (This agreement applies <br />only to the extent that you perform work under a written contract that requires you to obtain this agreement <br />from us). <br />You must maintain payroll records accurately segregating the remuneration of your employees while <br />engaged in the work described in the Schedule. <br />The additional premium for this endorsement shall be 5010 of the California workers' compensation <br />premium otherwise due on such remuneration. <br />Schedule <br />Person or Organization <br />City of Santa Ana <br />APPROVED AS TO FORM <br />20 Civic Canter Plaza - Roaa Annex (M -36) <br />Santa Ana, CA 92701 7 '— <br />Laura Stitt ShcedY <br />Assistant City Attorncy <br />Job Description <br />All operations wbere required by written contract <br />WC 04 03 06 Countersigned by <br />(Ed. 4 -84) Authorized Representative <br />