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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />WC 04 03 06 <br />(Ed. 04-84) <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 <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 the <br />work described in the Schedule. <br />The additional premium for this endorsement shall be 2.0% of the California workers' compensation premium <br />otherwise due on such remuneration. <br />Any person or organization for which you have agreed to waive your rights of recovery in a written contract, provided <br />such contract was executed prior to date of loss. <br />Person or Organization <br />Schedule <br />Job Description <br />ANY PERSON(S) OR ORGANIZATION(S) WITH WHOM YOU HAVE AGREED TO SUCH A WAIVER, IN A VALID <br />WRITTEN CONTRACT OR WRITTEN AGREEMENT THAT HAS BEEN EXECUTED PRIOR TO LOSS. <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 only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective <br />Insured <br />Insurance Company <br />11 /30/2024 <br />Hunter Consulting, Inc. <br />PRAETORIAN INSURANCE <br />COMPANY <br />Policy No. 202001426 <br />Countersigned by <br />Endorsement No. 000 <br />Premium <br />WC 04 03 06 Page 1 of 1 <br />(Ed. 04-84) <br />