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Workers' Compensation and Employers' Liability Policy Named Insured Endorsement Number VERALTO CORPORATION CIO DANAHER CORPORATION Policy Number 2200 PENNSYLVANIA AVE, N.W. #800W Symbol: WLR Number. C70317801 Policy Period Effertilve Date of Endorsement 05-30-2023 TO og- o-2o24 09-30-2023 Issued By [Name of Insurance Company] ACE AMERICAN INSURANCE COMPANY Insert the policy number. The remalnder of the Information Is to be completed only when this endorsement Is Issued subsequent to the prepandlon of the policy. This endorsement changes the policy to which It Is attached and Is effective an the date Issued unless otherwise stated. CALIFORNIA WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the Information Page. 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, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule, where you are required by a written contract to obtain this waiver from us. You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. Schedule 1. { } Specific Waiver Name of person or organization: X) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver. 2. Operations: ALL OPERATIONS CONDUCTED BY AN INSURED PURSUANT TO SUCH WRITTEN CONTRACT 3. Premium: The premium charge far this endorsement shall be 1.0 percent of the California premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described. 4. Minimum Premium: $0 Authorized Representative oR,N F Risk Mougmumt DMslm °K REVIEWED & APPROVED BY. o � Risk Management Specialist WC 90 03 75 (06/10)