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RJMDesign Group, Inc A-2003-023&A-2014-223-U1REVIEWED BY: , EUN|CEHERED|A(PG3OF5) <br />WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 99 03 76(00) — 001 <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />ENDORSEMENT CALIFORNIA <br />(BLANKET WAIVER) <br />We have the righttD recover our payments from anyone liable for on injury covered by this <br />policy. We will not enforce our right against the person or organization named in the Schedule. <br />You must maintain oavru| records accurately S8gnygoUng the remuneration of your <br />employees while engaged in the work described in the Schedule. <br />The additional premium for this endorsement shall be 3.00 96 of the California workers' <br />compensation premium otherwise due on such remuneration. <br />Person orOrganization <br />ALL PERSONS ORORGANIZATIONS <br />THAT REQUIRES YOU TOOBTAIN <br />EXECUTED THE CONTRACT BEFORE <br />DATE C]FISSUE: s/zs/zozs <br />Schedule <br />Job Description <br />THAT ARE PxRTETOACONTRACT <br />THIS AGREEMENT, PROVIDED YOU <br />THE LOSS. <br />0TASSIGN: cA <br />