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Docusign Envelope ID: E360345A-EOA4-4122-A863-A57DF7B34CBO <br /> Workers'Compensation and Employers'Liability Policy <br /> Named Insured Endorsement Number <br /> OUTERONT MEDIA INC. <br /> 90 PARK AVENUE 9TH FLOOR Policy Number <br /> NEW YORK,NY 10016 Symbol:WLR Number: C55521530 <br /> Policy Period Effective Date of Endorsement <br /> 06-01-2024 TO 06-01-2025 06-01-2024 <br /> Issued By(Name of Insurance Company) <br /> INDEMNITY INS. CO. OF NORTH AMERICA <br /> Insert the policy number.The remainder of the Informatlon Is to be completed only when this endorsement is issued subsequent to the preparafion of the policy. <br /> TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> This endorsement applies only to the insurance provided by the policy because Texas 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 will not <br /> enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect <br /> to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract <br /> to obtain this waiver from us. <br /> This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> The premium for this endorsement is shown in the schedule. <br /> Schedule <br /> 1. { ) Specific Waiver <br /> Name of person or organization: <br /> { X } Blanket Waiver <br /> Any person or organization for whom the Named Insured has agreed by written contract to <br /> furnish this waiver. <br /> 2. Operations: <br /> ALL TEXAS OPERATIONS <br /> 3. Premium: <br /> The premium charge for this endorsement shall be 2.0 percent of the premium developed on <br /> payroll in connection with work performed for the above person(s) or organization(s) arising out of the <br /> operations described. <br /> 4. Advance Premium: <br /> Authorized Representative <br /> WC 42 03 04B (06114) 0 Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved. <br />