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AM, <br />TRAVELERSJ WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 00 03 13 (00)- <br />POLICYNUMBER: TC2JUB-744CL27-1-15 <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We VAIII not <br />enforce our right against the person or organization named in the Schedule, (This agreement applies only to the <br />extent that you perform work Linder a written contract that requires You to obtain thls agreement from us) <br />This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. <br />N1*1We1?T-1Xt=fi1a=1 *Ten <br />DESIGNATED ORGANIZATION: <br />ANY PERSON OR ORGANIZATION FOR WHOM A WAIVER OF <br />SUBROGATION 19 REQUIRED BY CONTRACT OR AGREEMENT OR <br />PERMIT, BUT COVERAGE 19 LIMITED TO THE SCOPE OF TEE <br />WORK PERFORMED BY THE INSURtO UNDER SUCH CONTRACT, <br />AGREEVENT OR PERMIT. <br />r-Po'%71FD AS TO'CORM <br />-YD <br />DATE OF ISSUIE' 09-14-15 ST ASS IGN: <br />