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Docusign Envelope ID:C101DF94-8EEA-4210-A163-1FB71C9DF46C <br /> DNA Workers Compensation And. Employers Liability Insurance <br /> Policy Endorsement <br /> BLANKET WAIVER OF OUR • RECOVER FROMOTHERS <br /> D <br /> N <br /> This endorsement changes the policy to which it is attached. <br /> It is agreed that Part One - Workers' Compensation Insurance G. Recovery From Others and Part Two - <br /> Employers' Liability Insurance H. Recovery From Others are amended by adding the following: <br /> We will not enforce our right to recover against persons or organizations. (This agreement applies only to the <br /> extent that you perform work under a written contract that requires you to obtain this agreement from us.) <br /> PREMIUM CHARGE - Refer to the Schedule of Operations <br /> The charge will be an amount to which you and we agree that is a percentage of the total standard premium for <br /> o California exposure. The amount is 2%. <br /> w <br /> All other terms and conditions of the policy remain unchanged. <br /> This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, <br /> m <br /> takes effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another <br /> effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy <br /> unless another expiration date is shown below. <br /> 0 <br /> a <br /> 0 <br /> C. <br /> w <br /> Ln <br /> co <br /> rn <br /> p <br /> H <br /> N <br /> ID <br /> M <br /> O <br /> 0 <br /> r <br /> ko <br /> 0 <br /> 0 <br /> w <br /> 0 <br /> m <br /> N <br /> O <br /> O <br /> O <br /> N <br /> b <br /> O <br /> O <br /> Form No:G-19160-B (11-1997) Policy No:6079684585 <br /> Endorsement Effective Date: Endorsement Expiration Date: Policy Effective Date:11/16/2024 <br /> Endorsement No: 2; Page: 1 of 1 Policy Page:45 of 66 <br /> Underwriting Company:The Continental Insurance Company, 151 N Franklin St, Chicago, IL 60606 <br /> ®Copyright CNA All Rights Reserved. <br />