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5 <br /> Ad <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> WAIVER OF OUR RIGHT TO RECOVER <br /> FROM OTHERS ENDORSEMENT . <br /> 3 <br /> Policy Number: 57 WEC AN1ML1 Endorsement Number: 003 <br /> Effective Date: 04/16/25 Effective hour is the same as stated on the Informatiq rage o p <br /> Named Insured and Address: WE ARE GROUNDSWELL r <br /> 1801 E EDINGER AVE STE 115 <br /> SANTA ANA CA 92705 <br /> We have the right to recover our payments from anyone liable for inju d by th' licy. We will not enforce our <br /> right against the person or organization named in the Schedule. <br /> This agreement shall not operate directly or indirectly to bene i yone` :amed in the Schedule. <br /> SCHED <br /> Any person or organization for whom yo ulred ct or agreement to obtain this waiver from us. <br /> Endorsement is not applicable in KY, NH, r f O constru 1 n risk <br /> Countersigned by <br /> Authorized Representative <br /> Form WC 00 03 13 Printed in U.S.A. <br /> Process Date: 04/16/25 Policy Expiration Date: 10/01/25 <br />