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Attachment Code: D466017 Certificate ID: 11767171 <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />WC 124 <br />(4 -84) <br />WC000313 <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy <br />unless a different date is indicated below. <br />(The following "attaching clause' need be completed only when this endorsement is issued subsequent to <br />preparation of the policy.) <br />This endorsement, effective on 4/30/2019 at 12:01 A.M. standard time, forms a part of <br />Policy No. 71750505 <br />issued to Best Best & Krieger LLP <br />of the FEDERAL INSURANCE COMPANY <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We <br />will not enforce our right against the person or organization named in the Schedule. This agreement <br />applies only to the extent that you perform work under a written contract that requires you to obtain <br />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 />JOB DESCRIPTION: ALL OPERATIONS BLANKET WAIVER —ANY PERSON OR <br />ORGANIZATION FOR WHOM THE NAMED <br />INSURED HAS AGREED BY WRITTEN CONTRACT <br />TO FURNISH THIS WAIVER. <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />MII <br />01. :1� <br />WC 124 (4-84) <br />WC 00 03 13 Copyright 1983 National Council on Compensation Insurance. <br />