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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br /> (Ed. 4-84) <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 enforce <br /> 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 anyone not named in the Schedule. <br /> Schedule <br /> Blanket waiver of subrogation as required by written <br /> contract <br /> This endorsement changes the policy to which it is attached and is effective on 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 Date;0 7/01/2 0 2 5 Policy No. SAMTWC 0 0 315 0 5 Endorsement No. <br /> Policy Effective Date: 07/01/2025 to 07/01/2026 Premium $ <br /> Insured: Waterline Technologies, Inc . <br /> DBA: <br /> Carrier Name/Code: ,Service American Indemnity Company (Method) <br /> WC 00 03 13 <br /> Countersigned by = <br /> (Ed. 4-84) <br /> 1983 National Council on compensation insurance. Page 1 Of 1 <br />