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Workers' Compensation and Employers' Liability Policy <br />Named Insured <br />MOBILE MINI, INC. <br />4646 E. VAN BUREN STREET <br />PHOENIX, AZ 85008 <br />Endorsement Number <br />Policy Number <br />Symbol: WLR Number:: C67814964 <br />Policy Period <br />11-01-2020 TO 11-01-2021 <br />Effective Date of Endorsement <br />11-01-2020 <br />Issued By (Name of Insurance Company) <br />ACE AMERICAN INSURANCE COMPANY <br />Insert the policy number. The remainder of the information is to be completed only when this endorsement is issued subsequent to the preparation of policy <br /> <br />CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> <br />This endorsement applies only to the insurance protected by the policy because California as shown in Item 3 .A of <br />the Information Page. <br /> <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. but this waiver applies only with respect to <br />bodily Injury arising out of the operations described in the Schedule, where you are required by a written contract to <br />obtain this waiver from us <br /> <br />You must maintain ·payroll records accurately segregating the remuneration of your employees while engaged in the <br />work described in the Schedule <br /> <br />Schedule <br /> <br />1. ( ) Specific Waiver <br />Name of person or organization: <br /> <br /> <br /> <br /> <br />( X ) Blanket Waiver <br />Any person or organization for whom the Named Insured has agreed by written contract to furnish this <br />waiver <br /> <br />2. Operations <br />ALL OPERATIONS CONDUCTED BY AN INSURED PURSUANT TO SUCH WRITTEN CONTRACT <br /> <br /> <br />3 Premium: <br />The premium charge for this endorsement shall be 2.0 percent of the California premium developed on <br />payroll in connection with work performed for the above person(s) or organization(s) arising out of the <br />operations described <br /> <br />4 . Minimum Premium o <br /> <br /> <br /> <br /> <br /> <br />w C 90 03 75 (05118) <br />11-01-2021 TO 11-01-2022 11-01-2021 <br />C68929507 <br />DocuSign Envelope ID: F8EBDA2B-E1C9-4C03-80ED-E37FE36A5811