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This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br />Policy No. ZAWCI9449804 Endorsement No. <br />Premium INCL. <br />Countersigned By <br />Endorsement Effective 10/01/2024 <br />Insured SIERRA NEVADA CONSTRUCTION, INC. <br />Insurance Company ARCH INSURANCE COMPANY <br />DATE OF ISSUE: 10-10-24 <br />WC 00 03 13 <br />(Ed. 4-84) <br />ã 1983 National Council on Compensation Insurance. <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <br />(Ed. 4-84) <br />POLICY NUMBER: ZAWCI9449804 <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 <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 />AS AGREED PER WRITTEN CONTRACT OR WRITTEN AGREEMENT <br />Mary Hearron <br />Docusign Envelope ID: F9AC9A1A-7D30-43C0-B525-C1635A73245B