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i <br /> BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br /> date is indicated below. <br /> (The.following "attaching clause" need be completed only when this endorsement is Issued subsequent to preparation of the pollcy). <br /> This endorsement, effective 12.01 AM 1 013 1/2024 forms a part of Policy No. WC 014-11-1905 <br /> Issued to XYLEM INC. <br /> By A I U INSURANCE COMPANY <br /> We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br /> our right against any person or organization with whom you have a written contract that requires you to obtain this <br /> .agreement from us,. as regards any work you perform for such person or organization. <br /> The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium <br /> for this policy. <br /> WC 04 03 61 <br /> (Ed, 11190) Countersigned by- - - - - - - _ _ _ _ _ — — — — — — <br /> Authorized Representative <br />