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WORKERS'COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY 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 enforce our right against the <br /> person or organization named in the Schedule.(This agreement applies only to the extent that you perform work under a written contract <br /> 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 described in the <br /> Schedule. <br /> The additional premium for this endorsement shall be %of the California workers'compensation premium otherwise due on such <br /> remuneration. <br /> Schedule <br /> Person or Organization Job Description <br /> All persons or organizations that are party to a Job performed for any person or organization that you <br /> contract that requires you to obtain this have agreed with in a written contract to provide this <br /> agreement,provided you executed the contract agreement. <br /> before a 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 O1/29/202S Policy No. PSW0006200 Endorsement No. <br /> Insured Smaart Power Insurance Company RLI Insurance Company <br />