CATHYJON ENTERPRISES, INC. DBA HB STAFFING

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KEY0145812 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 Policy Term: 01/01/2025 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET 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 person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule State Description AR Any party with whom the insured agrees to waive subrogation in a written contract. AZ Any party with whom the insured agrees to waive subrogation in a written contract. CA Any party with whom the insured agrees to waive subrogation in a written contract. CO Any party with whom the insured agrees to waive subrogation in a written contract. CT Any party with whom the insured agrees to waive subrogation in a written contract. DC Any party with whom the insured agrees to waive subrogation in a written contract. DE Any party with whom the insured agrees to waive subrogation in a written contract. FL Any party with whom the insured agrees to waive subrogation in a written contract. GA Any party with whom the insured agrees to waive subrogation in a written contract. ID Any party with whom the insured agrees to waive subrogation in a written contract. MD Any party with whom the insured agrees to waive subrogation in a written contract. MT Any party with whom the insured agrees to waive subrogation in a written contract. NC Any party with whom the insured agrees to waive subrogation in a written contract. OK Any party with whom the insured agrees to waive subrogation in a written contract. PA Any party with whom the insured agrees to waive subrogation in a written contract. TN Any party with whom the insured agrees to waive subrogation in a written contract. TX Any party with whom the insured agrees to waive subrogation in a written contract. UT Any party with whom the insured agrees to waive subrogation in a written contract. VA Any party with whom the insured agrees to waive subrogation in a written contract. VT Any party with whom the insured agrees to waive subrogation in a written contract. "P—", Risk ManagementDMsian REVIEWED & APPROVED BY. Afg Aezv WC 00 03 13 — 1-" Risk Management Specialist (Ed. 4-84) y NJ 78862138 q 2§$4-�o11�i2��,1PPiL'c7Yhl�s�y��924 7:46:01 PM (CST) Page 15 of 16 This certificate cancels and supersedes ALL previously issued certificates.