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BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS SNIDDRSENIIENT <br /> Thiv endorsement changes the policy to wkieh it is attached effective on the inception date of the policy unless a different <br /> dads-indiea��d-bQlovw: r <br /> Me fokming'a Meted only when ti'-T—r-n(or emenr Ia-1SSU E;WSVI Mht-icrprepara&xt ofthe policy},-- <br /> Ttils endorsement, effective 12.O1 Am 3,r1/2026 forms a part of Policy No. WC066656652 <br /> Issued to SHANNON. & WIL.SON, INC. <br /> By NATIONAL UNION FIRE 1NSURARCE COMPANY OF PITTSBURGH, P.A. <br /> We have a right to recover our payments from anyone liable for an Injury covered by this policy. We Wlil not enforce <br /> our right against any person or organization with whom you have a wrttten contract that regilres yoLi to obtain this <br /> agreement from us, as regards any work you perform for such person or organization- <br /> The additional premium for this endorsement shall be 2.00 % of the total estimated workers compensation premium <br /> for this policy. . <br /> Wts 04 D3 61 Countersigned b <br /> e /ry _ _ _-- _ — _ . . - - <br /> &u€harfzed Representative <br />