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Includes copyrighted material of the National Council on Compensation Insurance with its permission. <br />1983 National Council on Compensation Insurance. <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 98 01 11 <br />(Ed. 6-11) <br />BLANKET 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 our <br />right against any person or organization only to the extent that you perform work under a written contract that requires <br />you to obtain this agreement from us. <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: Policy No.: Endorsement No.: <br />Insured: Premium: <br />Insurance Company Countersigned by __________________________________________ <br />BUIILDERS MUTUAL INSURANCE COMPANY <br />WC 98 01 11 <br />(Ed. 6-11) <br />Docusign Envelope ID: 1161C0A3-27D1-45D2-B2D8-A2C8BF0ADDC9