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e <br /> <br /> <br /> <br /> California Surveying Corporation <br /> and The Martin Lloyd Corporation <br /> TRAVELERS WORKERS COMPENSATION <br /> AND <br /> EMPLOYERS LIABILITY POLICY <br /> ENDORSEMENT WC 99 03 76 (00) <br /> <br /> POLICY NUMBER: UB330OT887 <br /> <br /> <br /> WAIVER OF RIGHT TO RECOVER FROM OTHERS <br /> ENDORSEMENT - CALIFORNIA <br /> (BLANKET WAIVER) <br /> We have the right to recover our payments from anyone liable for an injury covered by this <br /> policy. We will not enforce our right against the person or organization named in the Schedule. <br /> You must maintain payroll records accurately segregating the remuneration of your employees <br /> while engaged in the work described in the Schedule. <br /> <br /> The additional premium for this endorsement shall be 3% of the California workers' <br /> compensation premium otherwise due on such remuneration. <br /> SCHEDULE <br /> <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> ALL PERSONS OR ORGANIZATIONS <br /> THAT ARE PARTIES TO A CONTRACT <br /> THAT REQUIRES YOU TO OBTAIN <br /> THIS AGREEMENT PROVIDED YOU <br /> EXECUTED THE CONTRACT BEFORE <br /> THE LOSS. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> DATE OF ISSUE: 7/16/2010 <br /> <br /> <br /> <br /> <br /> <br /> CERT NO.: 7831703 (AVC) Betty T- 7/16/2010 9:32:21 AM Page 2 of 2 <br />