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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> Mat.COP <br /> Insurance Companies <br /> COPPLRPOINT • ALASKA NATIONAL <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br /> our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br /> perform work under a written contract that requires you to obtain this agreement from us.) <br /> This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> Schedule <br /> Anyone for whom you have agreed to provide this Waiver subject to the terms of the endorsement. <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 10/01/2024 Policy No. WC1025048 Endorsement No. 3 <br /> Insured TCAG Inc. Tuttle Click Ford, Inc Premium $ 6,240.00 <br /> Insurance Company CopperPoint American Insurance Company Countersigned by inn <br /> Authorized Representative <br /> WC000313 <br /> (Ed. 04-1984) <br /> ©Copyright 1983 National Council on Compensation Insurance,Inc.All Rights Reserved. <br />