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<br />TRA VELERS <br /> <br />WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br /> <br />ENDORSEMENT WC 00 03 13 (00) - 03 <br /> <br />POLICY NUMBER: (PKUB-2324c73-2-08) <br /> <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> <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 /> <br />The agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> <br />SCHEDULE <br /> <br />DESIGNATED PERSON: <br /> <br />DESIGNATED ORGANIZATION: <br /> <br />ALL PERSONS OR ORGANIZATIONS THAT ARE PARTIES TO A CONTRACT <br />THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT, PROVIDED YOU <br />EXECUTED THE CONTRACT BEFORE THE LOSS. <br /> <br />DATE OF ISSUE: 01-25-08 <br /> <br />ST ASSIGN: <br />