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OLA REPUBLIC GENERAL INSUfiMCE OORPORA710M <br /> WAIVER OF OUR RIGHTTORECOW11%FROMi 01HERS ENDM!lMONT <br /> THIS EWORSEMI!NT CHANIM 3 THE POLICY, PLEABE RfJJ D IT C,AWk LLY-, <br /> THIS GNOORSEMENT MODIFIES INSURANCE PROVIDED UNDER THE FOLLOWIN3, <br /> WORMEW cOMPEN5ATtON AND EMPLOYERS'LIA9tLrrY INSURANCE <br /> Ws have 1ha right to ma,mr our payments from"liv Nttblo foram Inktfy amMd hythfs polloy. V0 will not 94forco <br /> our tight against the person or organization named In IN Boedule,'rills agr mMM npplles only to the axinnt that <br /> you porform work Under a written contract that roqulres you 10 obtain thls agreomanf trufrr us, <br /> T415 agreornenf shall not operate directly or indirectly to hanuM anyone not named In the ftMule. <br /> Schedule <br /> WHEN REQUIRED SY WRrrVM CONTRAGM <br /> The premium oforge forllgv endorsamont is $0.00 <br /> arried Inaurad Y/1LIiN71NE t;AUPA(U1TIAr¢ <br /> PotroyNumber A1CW49570902 Endorsarnse! o. <br /> o ay t' are na 10/01/09 <br /> 10 01 <br /> rq uao r arae GalfAgieer ConatxUcttQn Servtcos <br /> roducer 0 <br /> 10/01/09 <br /> T p R XUAW- <br /> VYC 9s 0319(DBIt)S) <br />