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MGT of America Consulting, LLC _ <br />. Policy 30,11086788 CA <br />0-19160-D <br />(Eel, 11107) <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />13LANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />This endorsement changes the policy to which It Is attached, <br />It is agreed that part One Workars' Compansattan insurance G. Recovery From Others and Part Two Employers' <br />Liability Insurance H, Reoovery From Others are amended by adding the tollowing: <br />We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that <br />you perform work under a written contract that requires you to obtain this agroemont from us.) <br />PREMIUM CHARGE - <br />The charge will be an amount to which you and we agree that is a percentage of the total standard premium for Califomia <br />exposure, The amount Is <br />G-19160.8 <br />(Ed, 11/97) <br />Page 1 of i <br />I <br />