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MGT of America Consulting, LLC <br />P011cy 3011086788 • CA <br />G -19160-D <br />(Ed. 11197) <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />This endorsement changes the policy to which it Is attached, <br />It Is agreed that part One Workers' Compensation Insurance G. Recovery From Where and Part Two Employers' <br />Llebllity Insurance H, Recovery From Others are amended by adding the toiloWing; <br />We will not enforce our right to recover against persons or organizations. (This agreement applies only to the extent that <br />you perform work undera written contract that requires you to obtain this agraemant from us.) <br />PREMIUM CHARGE - <br />The charge will be an amount to which you and we agree that la a percentage of the total standard premium for California <br />expoeure, The amount Is <br />G-19160-9 <br />(Ed, 11197) Pags 1 of 1 <br />I <br />