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BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the Polley to whloh it Is WWI* effective on the inception, date of the policy unless s different <br />date is iltdfbated below, <br />(rho) failowma ":attnohlntt olnuae" need be Completed only when 111ie eo(jursomont ID Innuatl eubeaepaent 90 prpperetiurt or tho policy), <br />This endorsement, effootive 12:01 AM 011DI 12016 forme a part of Policy No. WC 06 .-02»2aigj <br />Issued toSCHNEIDER ELECTRIO HOLDINGS, INC. <br />BYHEW HAMPSH I RE INSURANCE COMPANY <br />We have s right to recover our payments from anyone liable for an ln)ury covered by thla pallcy. We will not enforce <br />our right against any peroon or Organization with whom you have S wdW contract that requires you to Obtain theta <br />agreement from us, as regards any work you perform for such peNon or organization. <br />The additional premium for this endorsement shell be 2.00 % of the total estimated workers compensation prernium <br />for this policy. <br />RUC 04 03 CM counterslanoo by ............ ...._ _ � ".. "G' �h <br />(pd' 1'1100) <br />Authorized Reprosentautivo <br />