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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against the person or organization named in the Schedule. (This agreement applies only to the extent that <br />you perform work under a written contract that requires you to obtain this agreement from us). <br />The additional premium for this endorsement shall be 2 % of the total California Workers’ Compensation premium <br />otherwise due. <br />Schedule <br />Person or Organization <br />Any <br />person/organization for <br />whom the named insured is <br />required under written <br />contract to furnish this <br />waiver. <br />Job Description <br />ALL CALIFORNIA <br />OPERATIONS <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise <br />stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the <br />policy.) <br />Endorsement Effective: 6/4/2024 Policy No.: WPL 5078218 00 Endorsement No. 001 <br />Premium $ INCL. Insured Service Station Systems, Inc <br />Insurance Company INSURANCE COMPANY OF THE WEST <br />Countersigned By <br />WC 99 06 34 (Ed. 8-00) <br />INSURED <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 <br />(Ed. 8-00) <br />Docusign Envelope ID: 409F905D-6320-40C8-9B56-5DEB89094B4B