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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not en- <br />force our right against the person or organization named in the Schedule, (This agreement applies only to the extent that <br />you perform work under a written contract that requires you to obtain this agreement from us.) <br />This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. <br />Schedule <br />NY <br />ALL <br />PERSONS <br />OR <br />ORGANIZATIONS <br />ON <br />FILE <br />WITH <br />THE <br />INSURED <br />PA <br />ALL <br />PERSONS <br />OR <br />ORGANIZATIONS <br />ON <br />FILE <br />WITH <br />THE <br />INSURED <br />CT <br />ALL <br />PERSONS <br />OR <br />ORGANIZATIONS <br />ON <br />FILE <br />WITH <br />THE <br />INSURED <br />FL <br />ALL <br />PERSONS <br />OR <br />ORGANIZATIONS <br />ON <br />FILE <br />WITH <br />THE <br />INSURED <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise slated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective 09/01/2024 Policy No. 406-04-54-43-0006 Endorsement No. <br />Insured E . J . WARD, INC. Premium $ <br />Insurance company Atlantic Specialty Insurance Company <br />Countersigned By <br />WC 00 03 13 04 84 ©1983 National Council on Compensation Insurance. Page 1 of 1 <br />E-INSURED <br />