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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 <br /> (Ed.04-84) <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce <br /> our right against the person or organization named in the Schedule. (This agreement applies only to the extent that <br /> you perform work under a written contract that requires you to obtain this agreement from us.) <br /> You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the <br /> work described in the Schedule. <br /> The additional premium for this endorsement shall be % of the California workers'compensation premium <br /> otherwise due on such remuneration. <br /> Schedule <br /> Person or Organization Job Description <br /> Where required by contract <br /> Any person or organization to whom you become obligated to waive <br /> your rights of recovery against, under any contract or agreement you <br /> enter into prior to the occurrence of loss. <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.(The <br /> information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br /> Endorsement Effective: 5/21/2025 Policy No.: 100 0004638 Endorsement No.: <br /> Insured:Integrated Demolition&Remediation,Inc. Premium: <br /> Insurance Company:Starr Indemnity&Liability Company Countersigned by: <br /> WC 04 03 06 <br /> (Ed. 04-84) Page 1 of 1 <br />