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WORKERS COMPENSATION ANC 1PLOYERS LIABILITY INSURANCE POr f WC 00 03 13 <br />(Ed. 4-84) <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 enforce <br />our right against the person or organization named in the Schedule. (This agreement applies only to the extent that <br />you perform work under a written contract that requires you to obtain this agreement from us.) <br />This agreement shallnot operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />Per the attached certificate <br />This endorsement changes the policy to which it is attached and Is effective on the date issued unless otherwise stated. <br />(The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement -Effective : 09/012011 Policy No. PSW0001177 Endorsement No. <br />Insured: Gillis & Panichapan Premium <br />Insurance Company. RLI Ins Co Countersigned by <br />WC000313 <br />(Ed. 4-84) <br />0 1083 H&Uonal Council on Compenaadon Insurance. <br />