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000u Envelope ID:roAooEuE-5oEo44ue-Bouu 18omo4E11o1u <br /> WMORKER5 C0MPEN5ATONAND EMPL0YER5 LIABILITY INSURANCE POLICY WC 00 0313 <br /> (Ed. 4-84) <br /> WAIVER OP OUR RIGHT TORECOVER FROM OTHERS ENDORSEMENT <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br /> our right against the person or organization named in the Schedule. (This agreement applies only to the extent that <br /> you perform work under a written contract that requires you to obtain this agreement from us.) <br /> This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> Schedule <br /> Effective Expiration Persons Organization <br /> 12/31/2015 12/31/2016 blanket blanket <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br /> Endorsement Effective 1281/201512:00:00 AM Policy No. VVC100'0002205'2015A Endorsement No. O <br /> Insured Corley HedfootArchitects, Inc. Premium $5.190 <br /> Insurance Company Countersigned by <br /> Stonmvwmod Insurance Company <br /> VVCO00313 <br /> (Ed. 4'84) <br /> 0 1983 National council on Compensation Insurance. <br />