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WAIVER OF OUR RIGHT TO RECOVER PROM OTHERS ENDORSEMENT <br />CAUFORNIA <br />We have the right to recover our payments from anyone liable for an Injury covered by Oils poNcy, We will not <br />enforce our right against the person or organization named In the Schedule, (This agreement applies only to the <br />aatan(that you perform work Under a Written oonhact that requires you to obtain this agreement from us.) <br />You must maintain payroll records scarrately, ssgragating the remuneration of your employees white engaged In <br />the work described in the Schedule.. <br />The additional premium for this sndorsoment shell be OOA of the California workers' compensation premium <br />othonvise due on such remuneration. <br />Schedule <br />Additional premium Is a percent of the Oaltfomts Manual Workers Compensation promium, Subject to a minimum <br />premium charge of $ <br />Premium to Included In the <br />applicable state blanketwelvePs <br />premium charge, <br />REVItWED & APPROVED <br />Ry Risk MANAC}EMENf Di WON <br />Issued by Liberty Mutual PiroNtsursnoe Gampany 19t3II6' ' j���, <br />For adsohment to polloy No. WC2.515.0071 fi5-010 Wive Ne� 0 Prep}lyin 4 <br />Issued to AkaMed Health So Moes CoWdon moE A CfiVE€iO <br />WC 04 OII as <br />PdI 04/1e84 Page 1 01 1 <br />