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G-191 60-B <br />CNA (Ed. 11197) <br />CA— Policy 301186788 <br />WORKERV COMPENSATION AND EMPLOYERS' UABILrTY INSURANCE POLICY <br />BLANKIET WAP4115A OF OUR RIGHT TO RECOVER FROM OTHERS <br />This endorsement changes the policy to which it is attached, <br />It Is agreed that Part One Workers'Comperawtion Inamence G. Recovery From O"W* and Part Two Employers' <br />Lk WIlty 10mmanee H. Recovery From 00wa are amended by adding the following: <br />We will not enforce our right to recover against persons or organizations. (This agreement applies only to the Went that <br />you perform work under a written contract that requires you to obtain this agreement from us,) <br />PREMIUM CHARGE- $9 <br />The charge will be an amount to which you and we agree that is a percentage of the total standard premium for Calidomia <br />exposure. The amount is -%. <br />G-19160-6 Page I of 1 <br />(Ed. 11/97) <br />