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WORKERS' COMPENSATION AND EMPLOYERS' UABiLfTY INSURANCE POLICY <br />WC 99 03 04 (Ed. 7.08) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT -- <br />CALIFORNIA <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a <br />different date is indicated below. <br />(Tho following "attaching clause need be completed only when this endorsement is Issued subsequent to preparation of the poilcy.) <br />This endorsement, effective on 02/01/15 at 12:01 A. M. standard time, forms a part of <br />(DATE) <br />Policy No, (16)7174.98-12 of the FEDERAL INSURANCE COMPANY <br />(NAME OF INSURANCE COMPANY) <br />Issued to INFOSEND INC <br />Endorsement No. <br />Authorized Representative <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against the person or organization named in the Schedule. The additional premium for the blanket waiver <br />offered by this endorsement shall be 1.00% of total California premium. <br />Schedule <br />Parson or Organization <br />BLANKET WAIVER - ANY PERSON OR ORGANIZATION <br />FOR WHOM THE NAMED INSURED HAS AGREED BY <br />WRITTEN CONTRACT TO FURNISH THIS WAIVER <br />WC 99 03 04 (Ed, 7-08) <br />.Bob Description <br />ALL CALIFORNIA OPERATIONS <br />Z <br />