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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY wc 00 0313 <br />(Ed.4-84) <br />WAIVER OF OUR RIGHTTO RECOVER FROM OTHERS ENDORSEMENT <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 <br />the 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 anyone not named in the Schedule. <br />Schedule <br />A}IY PERSON OR ORGAI{IZATION I{HEFC I{AIVER OF OT'R RIGHT TO <br />RECOVER IS PERMITTED BY I,AW AND IS REQUIRED BY VTRITTEN <br />CONTRACT PROVIDED SUCH CONTRJACT PROVTDED SUCH CONTR,ACT TiIAS <br />EXECUTED PRIOR TO DATE OF LOSS <br />This endorsement changes the policy to which it is aftached and is effective on the date issued unless otherwise stated. <br />(The information below is required onty when this endorsement is issued subsequent to preparation ol the policy.) <br />Endorsement Effective o7lo1t2o25 Policy No. zAwcl1830008 <br />lnsured The lnside Source, lnc. <br />lnsurance Company ARCH INSURANCE COMPANY <br />Endorsement No. <br />Premium INCL. <br />@ 1983 Nalional Council on Compensalion lnsutance. <br />Countersigned BY