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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 <br />(Ed. 8-00) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -BLANKET <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 or organization named in the Schedule. (This agreement applies only to the <br />extent that you perform work under a written contract that requires you to obtain this agreement from us). <br />The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium <br />otherwise due. <br />Schedule <br />Person or Organization Job Description <br />ANY PERSON OR ORGANIZATION ALL CALIFORNIA OPERATIONS, <br />FOR WHOM THIS WAIVER IS <br />REQUIRED. <br />Policy Number: WVE 5030354 01 Insured: Crosstown Electrical & Data Inc <br />Endorsement Effective: 6/3/2016 Coverage Provided by: Insurance Company of the West <br />Issue Date: 5/27/2016 Countersigned by: <br />f <br />WC 99 06 34 1 <br />(Ed. 8-00) <br />REVIEWED BY, (r EUNICE HEREDIA (PGqu) <br />