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_WORKERS COMPENSATION.AIy[Z Eh1lPLOYFRS I IARII ITYINSUgANCE_POLICY_.. WC 99 AA 90 C <br /> LEd.0�1-19) <br /> WAIVER OF OUR RIGHT TO RECOVER.ERQM OTHERS ENDORSEMENT-CALIFORNIA <br /> BLANKET BASIS <br /> We have the right to recover our payments from anyone liable for an Injury covered by this policy.We will not_enfarre. <br /> our right against the person or organization named in the Schedule.(This agreement applies only to the extent that you <br /> perform work under a written contract that requires you to obtain this agreement from us. <br /> The additional premium for this endorsement shall be calculated by applying a factor of 2%to the total manual <br /> premium,with a minimum initial charge of$3E then applying all other pricing factors for the pa kbis ralrulatad <br /> charge to derive the final cast of this endorsemen. <br /> This agreement shall not operate directly or Indirectly to benefit anyone not named In the Schedule. <br /> SchedulSlanksMabw <br /> Person/Organization Blanket Waiver—Any person or organization for whom the Named Insured he <br /> wed by written contract to furnish this waiver. <br /> Job Dsserloti.oU _ Waiver Premium(priorto adjustments) <br /> All CA Operations $4 209 <br /> This endorsement changes the poll to which It is attached and Is effective an 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: 3l11512025 PoIIcyNo.: _ FOWC623693 Endomemant-N .: <br /> Insured: Premium <br /> Insurance Company: Berkshire Hathaway Homestate Ins Co <br /> Countersigned by <br /> WC990410-C <br /> _(Ed.01-19) <br />