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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 <br /> enforce our right against the person or organization named in the Schedule. (This agreement applies only to the <br /> extent that you 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 /> Not applicable in Alaska, Kentucky, New Hampshire and New Jersey. <br /> The Waiver does not apply to any right to recover payments which the <br /> Minnesota Workers Compensation Reinsurance Association may have or pursue <br /> under M.S. 79.36. <br /> Schedule <br /> Any person or organization for which the employer has agreed by written contract, executed prior to loss, may <br /> execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver <br /> of subrogation does not apply to any construction group of classifications as designated by the waiver of right to <br /> recover from others (subrogation)rule in our manual. <br /> Where required by contract or written agreement prior to loss and allowed <br /> by law. <br /> In the states of Arizona and North Carolina, the premium charge is 2% of <br /> the total manual premium, subject to a minimum premium of$100 per policy. <br /> In the states of Connecticut, Florida, Iowa, Maryland, Nebraska and <br /> Oregon, the premium charge is 1% of the total manual premium, subject to <br /> a minimum premium of$250 per policy. <br /> In the state of Louisiana, the premium charge is 2% of the total standard <br /> premium, subject to a minimum premium of$250 per policy. <br /> In the state of Hawaii, the premium charge is$5,509 and determined as <br /> follows: The premium charge for this endorsement is VA of the total <br /> manual premium, subject to a minimum premium of$250 per policy. <br /> In the state of Massachusetts, the premium charge is 1%of the total <br /> manual premium. <br /> In the state of New York, the premium charge is 2% of the total manual <br /> premium, subject to a minimum premium of$250 per policy. <br /> In the state of Virgina, the premium charge is 5% ofthe total manual <br /> premium, subject to a minimum premium of$250 per policy. <br /> Issued by First Liberty Insurance Corporation <br /> For attachment to Policy No :WA666D066493033 Effective Date :8/1/2023 Premium$ <br /> Issued to Swinerton Incorporated <br /> a ors.\�s R1ekMatitagemettED,vtsfon <br /> N REVIEWED&APPROVED BY: <br /> � Id c A Acev44 <br /> WC 00 03 13 ©1983 National Council on Compensation Insurance. us Risk Management Specialist „ <br /> Ed.04/01/1984 / <br />