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Forming a part of <br /> Policy Humber: WCF405079 <br /> Coverage Is Provided In <br /> Named Insured: <br /> Super Birthday, Inc gent: Michael Roaden <br /> 1941 California Ave. #77591 <br /> Corona, CA 92877 Agent Code: 10161 <br /> Agent Phone: 859-586-8580 <br /> 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 enforce our <br /> right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br /> 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 /> City of Santa Ana, its City Council, its officers, <br /> officials, <br /> employees, agents, and volunteers <br /> 20 Civic Center Plaza, M-42 <br /> Santa Ana, CA 92701 <br /> WC 00 03 13 (04/84) <br />