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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> wcoaas13 <br /> (Ed.4-84) <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 enforce our <br /> right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br /> 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 /> City of Santa Ana, <br /> its City Council, officers, officials, employees, agents, <br /> and volunteers <br /> This endorsement changers the policy to which it is attached Ind is effective on the date issued unless otherwise stated <br /> (The information below is required only when this endorsemmont is issued subsequent to preparation of the policy.) <br /> Endorsement Effective: 3/I/2025 Policy No.:E IG5876182-00 Endorsement No, i <br /> Insured: 0N,0C <br /> Premium$ <br /> Insurance Company:Employers Compensation Insurance Company Countersigned by d an Dunl <br /> WC 00 03 13 <br /> (Ed. 4-84) Copyright 1983 National Council on Compensation Insurance. <br />