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AW <br />TRAVELERS � �� WORKERS COMPENSATION <br />� <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT VVC0UO313(OU)- <br />POLICY NUMBER: XJUB4342T25016 <br />INSURED: Mark Thomas & Company, Inc. <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not <br />enforce our right against the person ororganization named inthe Schedule, (This agreement applies only tothe <br />extent that you perform work under awritten contract that requires you toobtain this agreement from ue.) <br />This agreement shall not operate directly orindirectly tmbenefit any one not named inthe Schedule. <br />RqRwaff-plux,il <br />DESIGNATED PERSON: <br />ANY PERSON QRORGANIZATION FOR WHICH <br />THE INSURED HAS AGREED 8YWRITTEN <br />CONTRACT EXECUTED PRIOR TOLOSS TO <br />FURNISH THIS WAIVER <br />DESIGNATED ORGANIZATION: <br />DATE OFISSUE: 09-15-18 GTA8S|GN: 1. <br />w�m`' 1 16-17 5/zo1^ z.�y.^v m 'ar, I v~wf 10 <br />