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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different <br />date is Indicated below. <br />(The following "attaching clause" read be completed only when this endorsement is Issued subsegbent to rreparahon of the pdicyi. <br />This endorsement, effective 12:01 AM 07/01/14 forms a part of Policy No. WC 34157315 <br />Issued to NORTHSTAR DEMOLITION AND REMEDIATION, LP <br />By NEW HAMPSHIRE INSURANCE COMPANY <br />Premium I NCLUDED <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against the person or organization named in the Schedule. This agreement applies only to the extent that you <br />perform work under a written contract that requires you to obtain this agreement from us. <br />This agreement shall not operate directly or Indirectly to benefit any one not named In the Schedule. <br />Schedule <br />THE PREMIUM FOR THE ENDORSEMENT IS INCLUDED <br />ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE <br />ENTERED INTO A CONTRACT, A CONDITION OF WHICH <br />REQUIRES YOU TO OBTAIN THIS WAIVER FROM US. <br />THIS ENDORSEMENT DOES NOT APPLY TO BENEFITS OR <br />DAMAGES PAID OR CLAIMED: <br />I. PURSUANT TO THE WORKERS' COMPENSATION OR <br />EMPLOYERS' LIABILITY LAWS OF KENTUCKY, NEW <br />HAMPSHIRE, OR NEW JERSEY; OR, <br />2. BECAUSE OF INJURY OCCURRING BEFORE YOU <br />ENTERED INTO SUCH A CONTRACT. <br />APPROVED AS TO FORM <br />Laura A. Rossini <br />Senior Assistant City Attorney <br />This form is not applicable in California, Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee, <br />Texas, Utah, or Washington. <br />WC 00 03 13 <br />(Ed. 04/84) <br />Countersigned by <br />Authorized Representative <br />