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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF OUR RIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />Policy Number: L6 WEG B❑3❑P❑ Endorsement Number: <br />Effective Date: 11/04/20 Effecti!E0 E0:1r is t:10 same as stated on t❑e Information Page of t�le policy. <br />Named Insured and Address: Beginners Edge Sports Training <br />::432 E TIERRA B❑E❑A Li❑ <br />SCOTTSDALE A❑ 8E260 <br />We EIOFA� tip rigiA to recoFor oil- payments from anyone liaise for an inFiry co:�Ored i❑y t[js policy. We will not enforce oEr <br />rig❑t against t0a person or organiE8tion named in t0e Sc ed:le. bus agreement applies only to tEie eEtent tEat yo❑ <br />perform wor❑ Ender a written contract tilt re❑EJres yo❑to oEtain tips agreement from iDs.❑ <br />Yo❑ milt maintain payroll records acciiately segregating t❑e remiEneration of yob employees wile engaged in tEJe wori❑ <br />descrl❑ed in tip Sci—ed:le. <br />T❑e additional premi::n for tus endorsement sell Da ❑ ❑ of tip California wormers -compensation premi::n oti-erwise d❑e <br />on s❑c❑remEneratio n. <br />SCHEDULE <br />Person or Organization <br />City of West ❑ollywood, 8300 Santa Monica BlEd, West <br />❑ollywood, CA 90069. <br />CoiEntersigned ❑y <br />Job Description <br />003 <br />Ail❑ori::Od Representatii-:0 <br />Form WC 04 03 06 :1 ❑Printed in D.S.A. <br />Process Date: 11/04/2❑ Policy Expiration Date: 11/04/26 <br />