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Hanover <br />Insurance Group, <br />WZFD928932 5701761 <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br />right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform <br />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 the work <br />described in the Schedule. <br />The additional premium for this endorsement shall be 2 <br />due on such remuneration. — <br />Person or Organization <br />APPLIES AS BLANKET WAIVER <br />FOR THOSE HAVING A WRITTEN <br />CONTRACT WITH THE POLICY— <br />HOLDER REQUIRING WOS FOR <br />WC POLICYHOLDER EMPLOYEES. <br />_/ of the California workers' compensation premium otherwise <br />Schedule <br />Job Description <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 orYy when this endorsement Is Issued subsequent to preparation of the policy.) <br />Endorsement Effective 07/01/2020 Policy No. WZF-D928932-01 Endorsement No. <br />Insured STETSON ENGINEERS INC. <br />Insurance Company THE HANOVER AMERICAN INSURANCE COMPANY <br />Countersigned ByL <br />WC 04 03 06 (Ed 04-84) <br />016&52 <br />Risk Mnnage erd Division <br />[REVIEWED&AP1P,RO)V}EDBY].' <br />Risk Management Malyst <br />