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CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> This endorsement applies only to the insurance provided by the policy because California is shown in Item 3,A. of the <br /> Information Page. <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy. We wiil not enforce <br /> our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury <br /> arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver <br /> 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 /> Schedule <br /> 1. (❑) Specific Waiver <br /> Name of person or organization <br /> BLANKET WAIVER-ANY PERSON OR ORGANIZATION <br /> FOR WHOM THE NAMED INSURED HAS AGREED <br /> BY WRITTEN CONTRACT TO FURNISH THIS WAIVER. <br /> (®) Blanket Waiver <br /> Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. <br /> 2. Operations: <br /> ALL CALIFORNIA OPERATIONS <br /> 3. Premium: <br /> The premium charge for this endorsement shall be 1% percent of the California premium developed on payroll in <br /> connection with work performed for the above person(s) or organization(s) arising out of the operations described. <br /> 4. Minimum Premium: <br /> Authorized Representative <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> (The information below is required only when this endorsement is issued subsequent to preparation of the policy,) <br /> Endorsement Effective 05-15--24 Policy No. 71750595 Endorsement No. 002 <br /> Insured LIEBERT CASSIDY WHITMORE A PROFESSIONAL Premium $ Incl. <br /> Insurance Company Federal Insurance Company <br /> Countersigned By <br /> WC 90 03 75 (05/18) <br /> Insured Copy <br />