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VWRKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 <br />(Ed. 4-84) <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 <br />enforce our right against the person or organization named In the Schedule. (This agreement applies only to the <br />extent that 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 <br />the work described in the Schedule. <br />The additional premium for this endorsement shail be 2% of the California workers' compensation premium <br />otherwise due on such remuneration. <br />Schedule <br />Any person or organization as required by written contract. $250.00 <br />This endorsement changes the policy to which it is attached and Jr. effective on the date issued unless otherwise stated. <br />Endorsement E ONO &1 -2013 POpayNo. SWC1024313 Endorsement No. VVCW306 <br />Insured Orange County Contractor Services Premium s ` <br />lnsurance Company Security National Insurance Company <br />Countersigned by <br />