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Named Insured: Nichols Consulting Engineers, CHTD Policy Number: PSW0001955 <br />WORKERS' COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 <br />(Ed. 04-84) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right <br />against the person or organization named in the Schedule. ("Phis agreement applies only to the extent that you perform work <br />under a written contract that requires you to obtain this agreement from us.) <br />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work <br />described in the Schedule. <br />The additional premium for this endorsement shall be % of the California workers' compensation premium otherwise due <br />on such remuneration. <br />Person or Organization <br />All persons or organizations that are party to a contract that <br />requires you to obtain this agreement, provided you <br />executed the contract before the loss <br />Schedule <br />Job Description <br />Jobs performed for an person or organization <br />that you have agreed with in a written contract <br />to provide this agreement <br />REVIEWED BY- EUNICE HEREDIA (PG 4[qF q ) <br />