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ENDORSEMENT AGREEMENT <br />BROKER COPY <br />WAIVER OF SUBROGATION <br />BLANKET BASIS <br />HOME OFFICE <br />SAN FRANCISCO EFFECTIVE DECEMBER 1, 2020 AT 12.01 A.M. <br />ALL EFFECTIVE DATES ARE AND EXPIRING DECEMBER 1, 2021 AT 12.01 A.M. <br />AT 12:01 AM PACIFIC <br />STANDARD TIME OR THE <br />TIME INDICATED AT <br />PACIFIC STANDARD TIME <br />CWE <br />1561 E ORANGETHORPE AVE STE 240 <br />FULLERTON, CA 92831 <br />WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br />LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br />NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br />ORGANIZATION NAMED IN THE SCHEDULE. <br />THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br />PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br />TO OBTAIN THIS AGREEMENT FROM US. <br />THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE <br />2.00% OF THE TOTAL POLICY PREMIUM. <br />SCHEDULE <br />PERSON OR ORGANIZATION JOB DESCRIPTION <br />ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br />FOR WHOM THE NAMED INSURED SUBROGATION <br />HAS AGREED BY WRITTEN <br />CONTRACT TO FURNISH THIS <br />WAIVER <br />9170147-20 <br />RENEWAL <br />SP <br />7-84-15-94 <br />PAGE 1 OF 1 <br />NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE <br />OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS <br />POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE <br />HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br />LIMITATIONS OF THIS ENDORSEMENT. <br />COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: NOVEMBER 25, 2020j� <br />AUTHORIZED REPRESENT IVE PRESIDENT AND <br />SCIF FORM 10217 (REV.7-2014) <br />HORaN <br />o r <br />11 <br />RiskMmRgementDMsian <br />REVIEWED & APPROVED BY: <br />cc �,q,q� <br />r R. v <br />Risk Management Analyst <br />