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<br />I <br />'I <br /> <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> <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 /> <br />j <br /> <br />(The followro -allachilg clallSe" need be comp/eled only when lhis endorsement is issued subsequent to preparatiJn of lhe policy). <br /> <br />This endorsement, effective 12:01 AM 01/01/2007 <br /> <br />forms a part of Policy No. we 757-81-76 <br /> <br />Issued to CONSOLI DATED ENG INEERING LABORATORI ES <br /> <br />By AMERICAN HOME ASSURANCE COMPANY <br /> <br />We have a right to recover our payments from anyone lable for an injury covered by this policy. We wi. not enforce <br />our right against any person or organization with whom you have a written contract that requires you to obtain this <br />agreement from us, as regards any work you perfonn fer such person or organization. <br /> <br />The additional premium for this endorsement shall be <br />for this policy. <br /> <br />2. % of the total estimated workers compensation premium <br /> <br />JO#- <br />~~~O <br />1\lta" <br /><<'Oi~O t:. ~ <br />1"01' -tO~C ". <br />. '€-' S \ '!..\o'(\\e, <br />\..\S~ C\\'J ~ <br />~"'0 ot :v) <br /> <br /> <br /> <br />-1 <br /> <br />we 04 0361 <br />(Ed. 11190) <br /> <br />Countersigned by <br /> <br />~~ <br /> <br />INSURED'S COpy <br /> <br />Authorized Representative <br /> <br />l------________,.--"...--_~_______.H_.______________..._. <br />, . . <br />