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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br />date is indicated below. <br />needs to be completed only when this endorsement is issued subsequent to preparation of the policy <br />(The following "attacking clause'.) <br />This endorsement forms a part of policy No. 5276Y46607 <br />Issuedto: RK engineering group, inc. <br />By. Travelers Casualty Ins. Co. of Ameri <br />Premium (if any) TBD <br />ry <br />right ave a right to ecover <br />or our pa ationtnamedmens fromain thenyone Schliabedule. (Thlse for an uagreeme covered applies onby this lly to the exte t that you e will not enforce our <br />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 the work <br />described in the Schedule. <br />dorsement shall be 2-5% of the California workers compensation premium otherwise <br />The additional premium for this an <br />due on such remuneration. <br />Schedule <br />Job Description <br />Person or Organization <br />City of Santa Ana <br />20 Civic Center Plaza <br />Santa Ana, CA 92701 <br />The City of Santa <br />employees, agents, <br />representatives <br />Ana, its officers, <br />volunteers and <br />`Ma-�--q 6. X-P <br />Countersigned by Authorized Representative <br />WC 04 03 06 <br />(Ed. 4-84) <br />