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t <br />awb <br />s� <br />MGT of Amarica, Ina Policy Sol 1086786 � QA <br />CNA G -t 918b•lt <br />(Ed.I1197) <br />WORKBRO' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />BLANKET WAIVER DP OUR RIGHT TO RMOVBR FROM OTHERS <br />'Phis endarsamant changes the policy to which t b abohad, <br />It la agr9ad that part One Workare' compensatloa Insurance & Raooverr�yr From Olhens and part Two Employers, <br />Llabflity htsurauao H. RerusVeryfmm Others are amended by adding the following; <br />We will not ahforoo our right to recover against persons or organizations. (This agresrnent applies only to the extant that <br />you perform work under a wdtlsn aontmatthat requires you to oblain this agreement from ns.) <br />P AUNIUM OHi1RdF- <br />The aharga V111 be en amount io which Vail and we agree that B a poroantMo of the total standard promlum for californis <br />exposure. The amount Is <br />a- 1910.13 <br />(Ed 11187) <br />Page 1 of 1 <br />