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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br />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 />SCHEDULE <br />Any Person or Organization as required by written contract or agreement that is <br />executed prior to the loss. <br />THIS FORM APPLIES ONLY TO THE FOLLOWING STATE(S) IF COVERED BY YOUR POLICY. IF A <br />STATE IS NOT LISTED BELOW, THIS FORM DOES NOT APPLY IN THAT STATE. - <br />AL, AK, AZ, AR, CO, CT, DE, DC, FL, GA, HI, ID, IL, IN, IA, KS, LA, ME, MD, MA, <br />MI, MN, MS, MO, MT, NE, NV, NM, NY, NC, OK, OR, PA, RI, SC, SD, IN, VT, VA, WV <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The Information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective 10/01/2024 Policy No. LDC4068970 Endorsement No. <br />Insured TETRA TECH, INC. Premium$ Included <br />Insurance Company Safety National Casualty Corporation <br />Countersigned By <br />WC 00 03 13 (04 84) Page 1 of 1 <br />©1983 National Council on Compensation Insurance. <br />