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it <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> TEXAS WAIVER OF OUR RIGHT TO <br /> RECOVER FROM OTHERS ENDORSEMENT <br /> Policy Number: 84 WE BC3WUM Endorsement Number: <br /> Effective Date: 01/01/26 Effective hour is the same as stated on the Information Page of the policy. <br /> Named Insured and Address: ADMINSURE, INC. <br /> 3380 SHELBY ST <br /> ONTARIO CA 91764 <br /> This endorsement applies only to the insurance provided respect to bodily injury arising out of the operations <br /> by the policy because Texas is shown in Item 3.A. of the described in the Schedule where you are required by a <br /> Information Page. written contract to obtain this waiver from us. <br /> We have the right to recover our payments from anyone This endorsement shall not operate directly or indirectly <br /> liable for an injury covered by this policy. We will not to benefit anyone not named in the Schedule. <br /> enforce our right against the person or organization The premium for this endorsement is shown in the <br /> named in the Schedule, but this waiver applies only with Schedule. <br /> Schedule <br /> 1. ( ) Special 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 furnish this waiver. <br /> 2. Operations: <br /> All Texas Operations <br /> 3. Premium: <br /> The premium charge for this endorsement shall be 2 percent of the premium developed on payroll in <br /> connection with work performed for the above person(s) or organization(s) arising out of the operations described. <br /> 4. Advance Premium: <br /> Form WC 42 03 04 B Printed in U.S.A. <br /> Process Date: 10/16/25 Policy Expiration Date: 01/01/27 <br />