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�_ <br />�_ <br />MGT of America, Inc. Policy 3011086788 Effective 7/1/1 0 -11 - CA <br />ANA � -1 s1 so -B <br />(Ed. 1 1 /97) <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />This endorsement changes the policy to which it is attached. <br />It is agreed that Part One Workers' Compensation Insurance G. R ®covery From Others and Part Two Employers' <br />Liability Insurance H. Recovery From Others are amended by adding the following: <br />We will not enforce our right to recover against persons or organizations. (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 />PREMIUM CHARGE - <br />The charge will be an amount to which you and we agree that is a percentage of the total standard premium for California <br />exposure. The amount is <br />G- 19160 -B <br />(Ed. 1 1/97) <br />Page 1 of 1 <br />