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ENDORSEMENT AGREEMENT <br /> STATE <br /> WAIVER OF SUBROGATION REP Dl <br /> BLANKET BASIS 9255171-25 <br /> RENEWAL <br /> SP <br /> HOME OFFICE 0-27-07-45 <br /> SAN FRANCISCO EFFECTIVE JUNE 5, 2025 AT 12.01 A.M. PAGE I OF I <br /> ALL EFFECTIVE DATES ARE AND EXPIRING JUNE 5, 2026 AT 12.01 A.M. <br /> AT 12:01 AM PACIFIC <br /> STANDARD TIME OR THE <br /> TIME INDICATED AT <br /> PACIFIC STANDARD TIME <br /> ORANGE COUNTY CHILDREN'S THERAPEUT <br /> 2215 N BROADWAY FL 1 <br /> SANTA ANA, CA 92706 <br /> WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br /> LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br /> NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br /> ORGANIZATION NAMED IN THE SCHEDULE. <br /> THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br /> PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br /> TO OBTAIN THIS AGREEMENT FROM US. <br /> THE ADDITIONAL, PREMIUM FOP, 'PHIS ENDORSEMENT SHALL BE <br /> 2.00% OF THE TOTAL POLICY PREMIUM. <br /> SCHEDULE <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br /> FOR WHOM THE NAMED INSURED SUBROGATION <br /> HAS AGREED BY WRITTEN <br /> CONTRACT TO FURNISH THIS <br /> WAIVER <br /> NOTHING N THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WANE OR EXTEND <br /> ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY <br /> OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE N THIS POLICY SHALL BE <br /> HELD TO VARY, ALTER, WANE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br /> LIMITATIONS N THIS ENDORSEMENT. <br /> COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 6, 2025 <br /> 2572 O O PRESIDENT AND CEO <br /> M IF FORM 10217 (F V.4-2018) OLD [P 217 <br />