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Attachment Code:D658506 Certificate ID:20958134 <br /> WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE COMPANY <br /> WC9903013 <br /> (Ed. 7-09) <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA <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 /> You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the <br /> work described in the Schedule. <br /> The additional premium for this endorsement shall be$ 500 <br /> Schedule <br /> Person or Organization: <br /> All persons or organizations as required by written contract executed prior to the date of loss. This only applies to <br /> contracts for work in CA. <br /> Job Description: <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise <br /> stated. <br /> (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br /> Endorsement Effective: 5/15/2026 <br /> Policy No.: WC092-00002-026 <br /> Endorsement No.: <br /> Insured: CATHYJON ENTERPRISES INC. <br /> Insurance Company: SUNZ Insurance Company <br /> WC 99 03 13 <br /> (Ed. 7-09) <br />