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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 <br />(Ed. 8-00) <br />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 <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 />The additional premium for this endorsement shall be % of the total California Workers’ Compensation <br />premium otherwise due. <br />Schedule <br />Person or Organization Job Description <br />ANY PERSON / ORG ALL CA OPERATIONS <br />WHEN REQUIRED BY <br />WRITTEN CONTRACT <br />Policy Number: Insured: <br />Endorsement Effective: Coverage Provided by: Insurance Co of the West <br />Issue Date: Countersigned by: <br />WC 99 06 34 <br />(Ed. 8-00) <br />Docusign Envelope ID: 15BEFC42-42DD-4448-945C-C64213009C94