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16The Hartford <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF OUR RIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />Policy Number: 6 WEG B❑3❑P❑ Endorsement Number: 003 <br />Effective Date: 03/12/26 EffectiEo Foil is tFia same as stated on t❑e Information Page of tie policy. <br />Named Insured and Address: Beginners Edge Sports Training <br />❑432 E TIERRA B❑E❑A L❑ <br />SCOTTSDALE A❑ 8E260 <br />We ❑a❑e t❑e rigA to reco-er o-r payments from anyone liade for an in❑ry coEered ❑y tEJs policy. We will not enforce oEir <br />rigEt against t❑e person or organiCation named in tEja Sc❑edde. ISEJs agreement applies only to t--:0 eEtent t❑at yo❑ <br />perform wor❑ Ender a written contract tit re❑EJres yo❑to oEtain tEJs agreement from E8.11 <br />Yo❑ mC:8t maintain payroll records accilrately segregating t❑e rem-neration of yo-r employees wile engaged in tie wor❑ <br />descried in tEle Sc❑ed!Fle. <br />Tie additional premi-n for t::js endorsement s❑all ❑e 1111 of t❑e California worEors❑compensation premi-n otierwise d❑e <br />on s❑c❑rem-neration. <br />SCHEDULE <br />Person or Organization <br />City of Santa Ana, its City Co❑ncil, officers, officials, <br />employees, agents and EoIEnteers, 20 CIAC CE❑TER <br />PLO, SA❑TA A❑IA, CA, 92F-01 <br />CoAtersigned ❑y <br />Job Description <br />AEtEofI❑ed Representati-e <br />Form WC 04 03 06 :1 []Printed in O.S.A. <br />Process Date: 03/12/26 Policy Expiration Date: 11/04/26 <br />