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Policy Number: WC 7501706 <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 <br />will not enforce our right against the person or organization named in the Schedule. (This agreement <br />applies only to the extent that you perform work under a written contract that requires you to obtain this <br />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 YOU ARE REQUIRED TO WAIVE YOUR <br />RIGHTS OF SUBROGATION AGAINST UNDER A WRITTEN CONTRACT OR <br />WRITTEN AGREEMENT. <br />WC 00 03 13 <br />(Ed. 4-84) <br />1983 National Council on Compensation Insurance. <br />Attachment Code: D568691 Certificate ID: 22338224 <br />Docusign Envelope ID: 48513E52-49F8-4485-A0EA-CA6398A3A6E9