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Hartford Casualty Insurance Company <br />Effective 6/1/17 to 611118 <br />THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. <br />WAIVER OF OUR RIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />PollcyNumber: 46 WE A04105 Endorsement Number: <br />Effective Date: 06/01/17 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address: HUITT-ZOLLARS, INC. <br />1717 MCKINNEY AVE STE 1400 <br />DALLAS, TX 75202 <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 />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in <br />the work described In the Schedule. <br />The additional premium for this endorsement shall be <br />premium otherwise due on such remuneration. <br />Person or Organization <br />ANY PERSON OR ORGANIZATION <br />FROM WHOM YOU ARE REQUIRED BY <br />WRITTEN CONTRACT OR AGREEMENT <br />TO OBTAIN THIS WAIVER OF RIGHT <br />FROM US. <br />SCHEDULE <br />2 % of the California workers' compensation <br />Job Description <br />ALL CALIFORNIA OPERATIONS <br />Countersigned by <br />Authorized Representative <br />Form WC 04 03 06 (1) Printed in U.S.A. <br />Process Data; 06/12/17 Policy Expiration Date: 06/01/18 <br />REVIEWED SY: EUHIOE HEREDIA (PGgwf <br />