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STATE Endorsement Agreement <br /> COMPENSATION <br /> INSURANCE Waiver of Subrogation <br /> FUND Blanket Basis <br /> 9352130-2026 <br /> Home office Renewal <br /> San Francisco SP <br /> All Effective Dates are 8-73-18-68 <br /> at 12:01 AM Pacific Page 1 of 1 <br /> Standard Time or the <br /> Time Indicated at Effective January 10, 2026 at 12:01 AM <br /> Pacific Standard Time and Expiring January 10, 2027 at 12:01 AM <br /> A'S CONSTRUCTION <br /> 1662 W MCFADDEN AVE <br /> SANTA ANA, CA 92704-3362 <br /> We have the right to recover our payments from anyone liable for an injury covered by this <br /> policy. We will not enforce our right against the person or organization named in the schedule. <br /> This agreement applies only to the extent that you perform work under a written contract that <br /> requires you to obtain this agreement from us. <br /> The additional premium for this endorsement shall be 2.00% of the total policy premium. <br /> Schedule <br /> Person or Organization Job Description <br /> Any person or organization for whom the Blanket Waiver of Subrogation <br /> named Insured has agreed by written <br /> contract to furnish this waiver <br /> Signature: t' ! Y <br /> Michael Ortiz(May 27,2026 14:24:34 PDT) <br /> Email: mortiz@santa-ana.org <br /> Nothing in this endorsement shall be held to vary, alter, waive or extend any of the terms, conditions, <br /> agreements,or limitations of this policy other than as above stated.Nothing elsewhere in this policy shall <br /> be held to vary, alter, waive or limit the terms, conditions,agreements or limitations in this endorsement. <br /> Countersigned and Issued at San Francisco January 9, 2026 <br /> 2572 Authorized Representative President and CEO SF—END <br /> Rev.2/2025 OLD DP 217 <br />