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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 C ra <br /> (Ed. 6. <br /> TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the <br /> Information Page. <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, but this waiver applies only with <br /> respect to bodily injury arising out of the operations described in the Schedule where you are required by a written <br /> contract to obtain this waiver from us. <br /> This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> The premium for this endorsement is shown in the Schedule. <br /> Schedule <br /> 1. Specific Waiver <br /> Contractor Name: <br /> Contractor Address: <br /> X Blanket Waiver <br /> Any person or organization for whom the Named Insured has agreed by written contract to furnish this <br /> waiver. <br /> 2. Operations: <br /> 3. Premium: <br /> The premium charge for this endorsement shall be 5 percent of the premium developed on payroll in <br /> connection with work performed for the above person(s) or organization(s) arising out of the operations <br /> described. <br /> 4. Advance Premium: $0.00 <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> Endorsement Effective 09/01/2025 Policy No. 4094950 Endorsement No. <br /> Insured Franklin Covey Co. Premium <br /> 13907 S Minuteman Dr Ste 500 <br /> Draper, UT 84020-9879 <br /> Insurance Company WCF Select Insurance Company <br /> Countersigned by <br /> WC 42 03 04 B <br /> (Ed. 6-14) <br /> 0 Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved. <br />