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TRAVELLERS J� WORKERS COMPENSATION <br /> ONE TOWER E EMPLOYERS LIABILITY POLICY <br /> FiARTFORD CT <br /> 0618� AND <br /> 0��. <br /> ENDORSEMENT WC 04 03 06 (01) — on <br /> POLICY NUMBER: TJB-00850202-25-42-G <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br /> ENDORSEMENT-CALIFORNIA <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. (This agreement applies only to the <br /> extent that you perform work under a written contract that requires you to obtain this agreement from us.) <br /> You must maintain payroll records accurately segregating the remuneration of your employees while engaged in <br /> the work described in the Schedule. <br /> THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE 5.00% OF THE CALIFORNIA WORKERS' <br /> COMPENSATION PREMIUM OTHERWISE DUE ON SUCH REMUNERATION. <br /> SCHEDULE <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> CITY OF SANTA ANA 20 CIVIC CENTER PLAZA (M-30) LANDLORD <br /> DATE OF ISSUE: 11-07-25 ST ASSIGN: Page I of I <br />