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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B <br />TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />ENDORSEMENT <br />This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of <br />the 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 <br />written 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 />Specific Waiver <br />(x) Blanket Waiver <br />Any Person or Organization as required by written contract or agreement that <br />is executed prior to the loss. <br />2. Operations: <br />3. Premium: $ <br />The premium charge for this endorsement shall be 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: <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 <br />10/01/2024 <br />Policy No. LDC4068970 <br />Endorsement No. <br />Named Insured 'TETRA <br />TECH, INC. <br />Premium $ Included <br />Insurance Company Safety National Casualty Corporation <br />Countersigned By <br />WC 42 03 04 B (06 14) <br />© Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved. <br />