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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 />have the <br />ht to <br />our <br />ments from <br />our right against the personror organ ation named in theone able for an Schedule. Injury <br />agreemecovered nt applithis es lonly. to, ll not extent thaenforce <br />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 <br />otherwise due, <br />5 <br />Person or Organization <br />ANY PERSON OR <br />ORGANIZATION WHEN <br />REQUIRED BY WRITTEN <br />CONTRACT <br />3 % of the total California Workers' Compensation premium <br />Schedule <br />Job Description ' <br />ALL CA OPERATIONS <br />G\���. <br />Q� <br />This endorsement 'hanges the policy to which It is attached and Is effective on the date issued unless otherwise stated. <br />(The Informatlo�below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) <br />Endorsement Effective 08/1.3/2018 Policy No. WSA 5037498 01 Endorsement No, <br />insured VALLEY MAINTENANCE CORPORATION Premium $ INCL. <br />Insurance Company INSURANCE COMPANY OF THE WEST <br />Countersigned By <br />WC 99 06 34 <br />(Ed. 8-00) <br />WSU850 <br />