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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 <br /> enforce our right against the person or organization named in the Schedule. (This agreement applies only to the <br /> extent that you 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 /> This endorsement is not applicable in AK, KY, NH and NJ. <br /> The waiver does not apply to any right to recover payments which the <br /> Minnesota Workers Compensation Reinsurance Association may have or pursue <br /> under M.S. 79.36. <br /> Schedule <br /> Any person or organization for which the employer has agreed by written contract, executed prior to loss, may <br /> execute a waiver of subrogation. However,for purposes of work performed by the employer in Missouri,this waiver <br /> of subrogation does not apply to any construction group of classifications as designated by the waiver of right to <br /> recover from others (subrogation) rule in our manual. <br /> Where required by contract or written agreement prior to loss and allowed <br /> by law. <br /> In the states of AL, AZ, AR, CO, DE. DC, GA, ID, IL, IN, KS, ME, MI, MN, <br /> MS, MO, MT, NV, NM, OK, PA, RI, SC, SD. VT and WV the premium charge is 0% <br /> of the total manual premium subject to a minimum premium of$0 per policy. <br /> In the states of CT, FL, IA, MD, NE and OR,the premium charge is 1% of <br /> the total manual premium, subject to a minimum premium of$250 per policy. <br /> In the state of HI, the premium charge is $250 and determined as follows: <br /> The premium charge for this endorsement is 1%of the total manual premium, <br /> subject to a minimum premium of$250 per policy. <br /> In the state of LA, the premium charge is 2% of the total standard <br /> premium, subject to a minimum premium of$250 per policy. <br /> In the state of MA, the premium charge is 1% of the total manual premium. <br /> In the state of NC, the premium charge is 2% of the total manual premium, <br /> subject to a minimum premium of$100 per policy. <br /> In the states of NY&TN, the premium charge is 2%of the total manual <br /> premium, subject to a minimum premium of$250 per policy. <br /> Rkk Mmwgmuw4 DhoWon <br /> i'g yr; ReVMD&APPWVED8y- <br /> A4ja Aa <br /> RfskManagementSped�IfsFi ' <br /> WC 00 0313 0 1983 National Council on Compensation Insurance. ` -.-._�.--� <br /> Ed.04/01/1984 <br /> 61 <br />