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WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />WC 04 03 06 <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— <br />CALIFORNIA <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 />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in <br />the work described in the Schedule. <br />The additional premium for this endorsement shall be <br />mium otherwise due on such remuneration. <br />Person or Organization <br />AS <br />REQUIRED BY WRITTEN <br />CONTRACT OR <br />AGREEMENT, EXECUTED <br />PRIOR TO LOSS, <br />EXCEPT WHERE SUCH <br />CONTRACTS OR <br />AGREEMENTS ARE NOT <br />PERMITTED BY LAW. <br />Schedule <br />Job Description <br />% of the California workers' compensation pre - <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DNISiON <br />WC 252 (4-84) <br />WC 04 03 06 (Ed. 4-84) Page 1 of 1 <br />