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The <br />Hancaver <br />Insurance Group. <br />WZCA399946 1309570 <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 our <br />right against the person or organization named In the Schedule. (This agreement applies only to the extent that you perform <br />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 work <br />described in the Schedule. <br />The additional premium for this endorsement shall be 2% % of the California workers' compensation premium otherwise <br />due on such remuneration. <br />Schedule <br />Person or Organization Job Description <br />ONLY WHERE REQUIRED BY CONTRACT <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below Is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective Policy No. WZC- A399946 -00 Endorsement No. <br />Insured Premium $ <br />Insurance CompanyTHE HANOVER AMERICAN INSURANCE COMPANY <br />Countersigned By <br />WC 04 03 06 (Ed. 04 -84) <br />