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STATE Endorsement Agreement <br /> COMPENSATION <br /> INSURANCE Waiver of Subrogation <br /> FUND Blanket Basis <br /> 9170623-2025 <br /> Home Office Renewal <br /> San Francisco SC <br /> All Effective Dates are 9-56-08-37 <br /> at 12:01 AM Pacific Page 1 of 1 <br /> Standard Time or the <br /> Time Indicated at Effective December 3, 2025 at 12:01 AM <br /> Pacific Standard Time and Expiring December 3, 2026 at 12:01 AM <br /> J & L CONSTRUCTORS INC. <br /> 10062 CYNTHIA DR <br /> HUNTINGTON BEACH, CA 92646-5439 <br /> We have the right to recover our payments from anyone liable for an injury covered by this <br /> policy. We will not enforce our right against the person or organization named in the schedule. <br /> This agreement applies only to the extent that you perform work under a written contract that <br /> requires you to obtain this agreement from us. <br /> The additional premium for this endorsement shall be of the total policy premium. <br /> Schedule <br /> Person or Organization Job Description <br /> Any person or organization for whom the Blanket Waiver of Subrogation <br /> named Insured has agreed by written <br /> contract to furnish this waiver <br /> Nothing in this endorsement shall be held to vary, alter,waive or extend any of the terms, conditions, <br /> agreements, or limitations of this policy other than as above stated.Nothing elsewhere in this policy shall <br /> be held to vary,alter,waive or limit the terms,conditions, agreements or limitations in this endorsement. <br /> Countersigned and Issued at San Francisco December 2,2025 <br /> 2572 Authorized Representative President and CEO SF—END <br /> Rev.2/2025 OLD DP 217 <br />