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WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY WC 00 03 13 <br />1 MN <br />(Ed.4-84) <br />WAIVER OF OUR RIGHT TO 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 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 anyone not named in the Schedule. <br />• Schedule. <br />ALL PERSONS) OR ORGA191ZATION(S) AS <br />REOLIIRED BY WRITTEN CONTRACT <br />LOC(S) ASSPECIFtEE IN <br />WRITTEN CONTRACT <br />This endorsement changes the policy to which it is attached effective on the date issued unless otherwise indicated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Endorsement Effective <br />Policy No. Endorsement No. 000 <br />Insured Premium $ <br />insurance Company Countersigned by <br />SECURA INSURANCE, <br />A Mutual Company <br />WC000313 <br />(Ed. 4-84) <br />©1983 National Council on Compensation. Insurance <br />