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TRAVELERS J� WORKERS COMPENSATION <br /> AND <br /> ONE TOWER SQUARE <br /> HARTFORD, Cr 06183 EMPLOYERS LIABILITY POLICY <br /> ENDORSEMENT WC 00 03 13(00)-01 <br /> POLICY NUMBER; UB-2J440716-17-26 <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 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 /> DESIGNATED PERSON: <br /> DESIGNATED ORGANIZATION: <br /> ANY PERSON OR ORGANIZATION FOR WHICH THE INSURED HAS <br /> AGREED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS TO <br /> FURNISH THIS WAIVER. <br /> DATE OF ISSUE,04/01/2018 ST ASSIGN: <br />