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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B <br /> TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br /> ENDORSEMENT <br /> This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of <br /> the 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 /> (x) Blanket Waiver <br /> Any Person or Organization as required by written contract or agreement that <br /> is executed prior to the loss. <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 /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br /> Endorsement Effective 10/Di/2024 Policy No. LDC4068970 Endorsement No. <br /> Named Insured TETRA TECH, INC. Premium $ Included <br /> Insurance Company Safety National Casualty Corporation <br /> Countersigned By <br /> WC 42 03 04 B(06 14) <br /> ©Copyright 2014 National Council on Compensation Insurance,Inc.All Rights Reserved. <br />