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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY VVCD00313 <br />(Ed. 04'84) <br />WAIV <br />ER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the right to recover our payments from anyone liable for en 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 iothe <br />axtentdhaiyoupodbrnnworkunderawhUenoonbaotthatrequireeyou(oobtaindhiaagreamentfromue.) <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />PER ATTACHED SCHEDULE DFHOLDERS <br />This endorsement changes the policy 8owhich it is attached and is effective on the date issued un|oao otherwise stated. <br />(The information below isrequired only when this endorsement is issued subsequent topreparation ofthe poUcy.) <br />Endorsement Effective O4/01/201G <br />Insured Iteris, Inc. <br />Insurance Company <br />American Zurich Insurance Company <br />WC 00 03 13 <br />Effective Policy No, VYCO1S1884OO <br />Countersigned by <br />Copyright 198oNational Council on <br />REVIEWED BY,-. <br />Endorsement No. <br />Premium $ N/A <br />Page 1of1 <br />Insurance, Inc, unnvnnpoma'm <br />