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WORKERS COMPENSATION AND ]EMPLOYERS LIABILITY INSURANCE POLICY NAVC 1400 0510 <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNLA, <br />We have thezight to recover ourpaymonts from anyone liable for an injury covered by this policy. We will not enforce ourright <br />against any person or organization named in the Schedule. (This agreement applies only be the extent fina you perform work <br />under a written contract that requires you to obtain this agreement from us.) <br />You trust maintain payroll records accurately segregating the remuneration of your employees while engaged in the work <br />described in the Schedule. <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />SdIrsdule <br />1, Blanket Waiver <br />Any person or organ vertion for whom the Named Insured has agreed by written contract to furnish this waher. <br />Z. Premium! <br />The additional premium charge for this endorgenicritshatl be 3 percent of the California Workers' Compensation pre-midrn <br />otherwise due subject to a athurnum premium of $750 per policy. <br />This andorsoment changes the policy to which it is attached and is effective on the date issued unless otherwise stated, <br />(Tho Information below Is required only when this..endorsement Is issued subsequent to preparation of the policy.) <br />Endorsement Effective 04/20=17 Policy No. MVVC0003633-07 Endorsement No. <br />Insured: $01 CONSULTING GROUP (A CORP) Premium (See Attached) <br />Insurance Company: Market Insurance Company Countersigned by <br />WWO44MOSID <br />Modes CopyPshied Mateolsl Of N a fionQ councs on C onoens alon In NPoomWILh its permission <br />Cop"M IM Nabonal courul on Cornponsoton Imrmnuo. <br />20 of" <br />