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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different <br />date is indicated below. <br />This endorsement, effective 12:01 AM 11/22/2023 <br />Issued to MOFFATT & NI CHOL <br />forms a part of Policy No. WC 19- 39- 7907 <br />By NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA. <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against the person or organization named in the Schedule. This agreement applies only to the extent that you <br />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 />ANY PERSON OR ORGANIZATION WITH WHOM YOU HAVE ENTERED INTO A CONTRACT, A CONDITION OF WHICH REQUIRES YOU TO OBTAIN THIS WAIVER FROM US. THIS ENDORSEMENT DOES NOT APPLY TO BENEFITS OR DAMAGES PAID OR CLAIMED: <br />1.PURSUANT TO THE WORKERS' COMPENSATION OREMPLOYERS' LIABILITY LAWS OF KENTUCKY, NEWHAMPSHIRE, OR NEW JERSEY; OR,2.BECAUSE OF INJURY OCCURRING BEFORE YOUENTERED INTO SUCH A CONTRACT. <br />This form is not applicable in Kansas for private construction contracts as defined in K.S.A. 16-1801 through K.S.A <br />16-1807 or public construction contracts as defined in K.S.A. 16-1901 through 16-1908, except where permitted by <br />statute or other applicable law, such as for use in wrap-up insurance programs. <br />Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute <br />a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of <br />subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover <br />from others (subrogation) rule in our manual. <br />This form is not applicable in California, Kentucky, New Hampshire, New Jersey, Texas, or Utah. <br />WC 00 0313 <br />(Ed. 04/84) <br />Countersigned by ---------------------- <br />Authorized Representative <br />Docusign Envelope ID: 8550A2C1-7DD2-41A8-96F8-EF3D050DCCEB