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DocuSign Envelope ID: 1AC635AA-EA4F-4955-BBE2-8A60C54AC4F9 <br /> WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br /> (Ed. 4-84) <br /> WAIVER OF OUR RIGHT TO RECOVER 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 you <br /> 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 /> Any person or organization for whom the Named Insured <br /> has agreed by written contract to furnish this waiver. <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 03/15/2022 Policy No. AF WCP 100014470 01 Endorsement No. <br /> Insured EASTERN TURF MAINTENANCE INC Premium: $0 <br /> Insurance Company ACCIDENT FUND NATIONAL Countersigned by <br /> INSURANCE COMPANY <br /> WC 00 03 13 <br /> (Ed. 4-84) <br /> ©1983 National Council on Compensation Insurance. <br />