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TEXAS WORKERS'COMPENSATION AND EMPLOYERS' LIABILITY MANUAL WC 42 03 04 A <br /> 1st Reprint Effective January 1, 2000 <br /> TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the <br /> Information Page. <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, but this waiver applies only with <br /> respect to bodily injury arising out of the operations described in the Schedule where you are required by a <br /> written contract to obtain this waiver from us. <br /> This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> The premium for this endorsement is shown in the Schedule. <br /> Schedule <br /> 1. ( ) Specific Waiver <br /> Name of person or organization <br /> ( X) Blanket Waiver <br /> Any person or organization for whom the Named Insured has agreed by written contract to furnish <br /> this waiver. <br /> 2. Operations: <br /> 3. Premium <br /> The premium charge for this endorsement shall be percent of the premium developed on payroll in <br /> connection with work performed for the above person(s) or organization(s) arising out of the operations <br /> described. <br /> * 4. Advance Premium <br /> Notes: <br /> Policy Number: SLICWC110660601 <br /> Effective Cate: 04101/2025 <br /> Insured Name: 02X Human Performance <br /> Service Lloyds insurance Co. NAIC#43389 <br />