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11/12/2024 <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br />date is indicated below. <br />(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). <br />This endorsement, effective 12:01 AM 03/01/2024 <br />Issued to t,�t Grath Fen odp <br />D�A: Mob(e o ular Management Corporation <br />forms a part of Policy No. WC015852320 (CA) <br />By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. <br />We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against any person or organization with whom you have a written contract that requires you to obtain this <br />agreement from us, as regards any work you perform for such person or organization. <br />The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium <br />for this policy. <br />APPROVED <br />By Cynthia Mora at 4:55 pm, Dec 02, 2024 <br />WC 04 03 61 Countersigned by _ _ _ _ _ _ <br />-- - - - - - - - - - - - - - - - <br />-- <br />(Ed. 11190) <br />Authorized Representative <br />62)07195 I MCG ENI 12024-25 GLI/%LS/CPP/CPU/WM I Mahesh Mylarappa 1 11/12/2024 4:52;29 PM (PST) I Page 15 of 16 <br />