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BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br />date Is indicated below. <br />(The following 'attaching clause` need be completed only Nhen this encorsement is issued subsequent to preparation of the policy). <br />This endorsement, effective 12:01 AM 04/01/2013 forms a part of Policy No, WC 033-57-5360 <br />Issued to UNITED TECHNOLOGIES CORPORATION <br />By NEW HAMPSHIRE INSURANCE COMPANY <br />We have a right to recover our payments from anyone liable for an Injury covered by this policy. We will not enforce <br />our right against any person or organization with whom you have a written contract that requires you to obtain this <br />agreement from us. as regards any work you perform for such person or organization. <br />The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium <br />for this policy. <br />}�Yy°,OVEN AS TO FORM <br />�— -� LISA ' � Attorney <br />Assistant City <br />WC 04 03 61 Countersigned by <br />(Ed.1L90t <br />Authorized Representative <br />