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<br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br /> <br />(Ed. 04-84) <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 <br />policy. We will not enforce our right against the person or organization named in the <br />Schedule. (This agreement applies only to the extent that you perform work under a written <br />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 <br />Schedule. <br />Schedule <br />All persons and / or organizations that are required by written contract or agreement with the <br />insured, executed prior to the Accident or Loss, that Waiver of Subrogation be provided <br />under this policy for work performed by you for that person and / or organization. <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 03/01/2024 Effective Policy No. WC 0081062 Endorsement No. <br />Insured M. Arthur Gensler Jr. & Associates, Inc.Premium $ <br />Insurance Company American Zurich Insurance <br />Company Countersigned by <br />WC124(4-84) <br />Page 1 of 1 <br />WC 00 03 13 Copyright 1983 National Council on Compensation Insurance, Inc. <br />Attachment Code: D461365 Certificate ID: 20089590 <br />Docusign Envelope ID: EA417244-1B08-4F71-884E-045B78625FB7