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140ME OFFICE <br />pDIjcy 1977624-2016 <br />SAN FRANCISCO <br />ALL EFFECTIVE DATES ARE <br />Policy Eff Date: 09/27116 <br />AT IL -01 AM PACIFIC <br />STANDARD TIME OR THE <br />Policy Exp Date: 09/27/17 <br />TIME INDICATED AT <br />PACIFIC STANDARD TIME <br />Endorsement Date: <br />Named Insured: Intorior Demolition ino <br />Addre,gs: 2621 1-10il6lulu Aw,, Xlopbwe, CA 91020 <br />09/27/16 <br />WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br />LIABLE FOR AN INIURY COVERED BY THTS POLICY. WE WILL <br />NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br />ORGANIZATION NAMED IN THE SCEEDULE. <br />THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br />PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br />TO OBTAIN THIS AGREEMENT FROM US. <br />THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SUALL BE <br />2.00% OF THE TOTAL POLICY PREMIUM. <br />KHEDULE <br />PERSON OR ORGANIZATION joB _aCRIPTIOF <br />ANY PKRSOK OR ORGANIZATION BLANKET WAIVER OP <br />FOR WHOM THE NAM INSURED SUBROGATION <br />HAS AGREED BY WRITTEN <br />CONTRACT TO FURNISH THIS <br />WART VER <br />NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE 94ELD TO VARY, ALTER, WAIVE <br />OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS <br />POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE <br />HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br />LIMITATIONS OF THIS ENDQRSFMNt <br />COUNTERSIGNED AND I$SUED AT SAN FNANCISCOe <br />16-4 <br />(koua. f4w-- <br />�AUI`HORIZED REPRESENT IVE PRESIDENT AND CEO <br />fiCir FORM 10217 (REVJ-200 <br />OLD Or' 217 <br />