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THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. <br />WAIVER OF OURRIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />Policy Number:76WEGAJ8HK6 Endorsement Number: <br />Effective Date:01/13/25Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address:PARTNERS IN CONTROL, INC. <br />9050 IRVINE CENTER DR STE 200 <br />IRVINECA92618 <br />Wehavetherighttorecoverourpaymentsfromanyoneliableforaninjurycoveredbythispolicy.Wewillnotenforceour <br />rightagainstthepersonororganizationnamedintheSchedule.(Thisagreementappliesonlytotheextentthatyou <br />perform work under a written contract that requires you to obtain this agreement from us.) <br />Youmustmaintainpayrollrecordsaccuratelysegregatingtheremunerationofyouremployeeswhileengagedinthework <br />described in the Schedule. <br />Theadditionalpremiumforthisendorsementshallbe2%oftheCaliforniaworkers'compensationpremiumotherwisedue <br />on such remuneration. <br />SCHEDULE <br />Person or OrganizationJob Description <br />Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from <br />us <br />Countersigned by <br />Authorized Representative <br />Form WC 04 03 06(1) Printed in U.S.A. <br />Process Date:12/04/24 Policy Expiration Date:01/13/26 <br />