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ENDORSEMENT AGREEMENT <br /> STATE WAIVER OF SUBROGATION <br /> INSURANCE COMPENSATION BLANKET BASIS 9170623-22 <br /> FUND RENEWAL <br /> SP <br /> HOME OFFICE 9-56-08-37 <br /> SAN FRANCISCO EFFECTIVE DECEMBER 3, 2022 AT 12 .01 A.M. PAGE 1 OF 1 <br /> AND EXPIRING DECEMBER 3, 2023 AT 12. 01 A.M. <br /> ALL EFFECTIVE DATES ARE <br /> AT 12:01 AM PACIFIC <br /> STANDARD TIME OR THE <br /> TIME INDICATED AT <br /> PACIFIC STANDARD TIME <br /> J & L CONSTRUCTORS INC. <br /> 29104 BASSWOOD <br /> LAKE ELSINORE, CA 92530 <br /> WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br /> LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br /> NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br /> ORGANIZATION NAMED IN THE SCHEDULE. <br /> THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br /> PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br /> TO OBTAIN THIS AGREEMENT FROM US. <br /> THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE <br /> 2.00% OF THE TOTAL POLICY PREMIUM. <br /> SCHEDULE <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br /> FOR WHOM THE NAMED INSURED SUBROGATION <br /> HAS AGREED BY WRITTEN <br /> CONTRACT TO FURNISH THIS <br /> WAIVER <br /> NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND <br /> ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY <br /> OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE <br /> HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br /> LIMITATIONS IN THIS ENDORSEMENT. <br /> COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: <br /> DECEMBER 6, 2022 <br /> 2572 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO <br /> SCIF FORM 10217 (REVA-2018) OLD DP 217 <br />