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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 07 00 A <br /> (Ed. 04-19) <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—BLANKET <br /> -CALIFORNIA <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br /> right against the person or organization for which you perform work under a written contract that requires you to obtain this <br /> agreement from us. <br /> The premium charge for this endorsement shall be 2% of the Worker's Compensation premium, subject to a minimum <br /> premium charge of$500. <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 1 1 11 4/2 025 Policy No. BNET729611432 Endorsement No. 0 <br /> Insured Sunny Hills Associates Incorporated Premium $53,159 <br /> Insurance Company Midwest Employers Casualty Company <br /> Countersigned by <br /> Authorized Representative <br /> WC990700A 1 of <br /> (Ed. 04-19) <br />