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vvurreers "rnpensauon ana <br />TYCO INTERNATIONAL. MANAGEMENT COMPANY, <br />LLC Policy Nuruher <br />9 ROSZEL ROAD <br />PRINCETON NJ 013540 SymboLWLR NumberC48592272 <br />10-01-2015 1-0 10-01-2016 <br />10 -01 -2015 <br />M1 <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will 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 under a written contract that requires you to obtain this agreement from us. <br />This agreement shall not operate directly or indirectly to benefit any one not named in the Schedule. <br />Schedule <br />ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR <br />RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS <br />EXECUTED PRIOR TO THE DATE OF LOSS. <br />For the states of CA, UT, TX, refer to state specific endorsements, <br />This endorsement is not applicable in KY, NH, and NJ. <br />Auth&Gze AAgent <br />WC 00 (Y3 13 (1'1105) C0pyrlcPub'1982 -83, National Cound on Compensation - <br />