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THIS ENDORSEMENT CHANGES THE POLICY' PLEASE READ IT CAREFULLY. <br /> WAIVER OF OUR RIGHT TO RECOVER FROM <br /> OTHERS ENDORSEMENT ~ CALIFORNIA <br /> Policy Number: 57VVEG ZJ1888 Endorsement Number: <br /> Effective Date: 05/01C25 Effective hour ia the same aa stated on the Information Page of the policy. <br /> Named Insured and Address: FEHF< & PEERS <br /> 100PF<|NGLE AVE STE000 <br /> WALNUT CREEK CA84580 <br /> VVe have the right to recover our payments from anyone liable for an injury oovenudbythiapo|ioy. VVe 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 /> You must maintain payroll nuoonda accurately segregating the remuneration of your employees while engaged in the work <br /> described in the Schedule. <br /> The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due <br /> on such remuneration. <br /> SCHEDULE <br /> Person mrOrganization Job Description <br /> Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from <br /> us <br /> Countersigned by <br /> Authorized Representative <br /> Form WC 0403 06 (1) Printed in U.S.A. <br /> Process Date: 04/15/25 Policy Expiration 0ate: 05/01C20 <br />