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Attachment Code : D544681 Master ID: 1444909, Certificate ID: 15189534 <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />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 <br />right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform <br />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 the work <br />description in the Schedule. <br />The additional premium for this endorsement shall be 2.0 of the California workers' compensation premium <br />otherwise due on such remuneration. <br />Schedule <br />Person or Organization <br />Any person or organization to whom you become obligated to waive your <br />rights of recovery against, under any contract or agreement you enter <br />into prior to the occurrence of loss. <br />Job Description <br />Where required by contract <br />This endorsement changes the policy to which it is attached and Is effective on the date issued unless otRe e stated. (The <br />Information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) <br />Endorsement Effective: 01/29/2018 <br />Policy No.: 100 0002615 <br />Insured: ALLIANCE ENVIRONMENTAL GROUP, INC. Premium: $1,594,368 <br />Insurance Company: STARR INDEMNITY & LIABILITY CO Countersigned by: <br />Endorsement No.: <br />WC 04 03 06 <br />(Ed. 04-84) Page 1 of 1 <br />