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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 <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 policy. We will not <br />enforce our right against the person or organization named in the Schedule. (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 />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTEN CONTRACT OR <br />AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE ACCIDENT OR LOSS, THAT WAIVER OF <br />SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT <br />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 Effective; 07/31/2024 <br />Insured Apex Companies, LLC <br />Effective Policy No. <br />Insurance Company Zurich American Insurance Company Countersigned by <br />Endorsement No. <br />Premium$ <br />WC124 (4-84) <br />WC 00 03 13 Copyright 1983 National Council on Compensation Insurance, Inc. <br />Page 1 of 1 <br />Uniform Forms™ <br />WC 6393347-00 <br />Docusign Envelope ID: 7B82E774-B23E-4A23-B6EA-1FF6A4BE7B49