SWINERTON BUILDERS - FIRST AMENDMENT (#2024549)

WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Not applicable in Alaska, Kentucky, New Hampshire and New Jersey. The Waiver does not apply to any right to recover payments which the Minnesota Workers Compensation Reinsurance Association may have or pursue under M.S. 79.36. Schedule Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. Where required by contract or written agreement prior to loss and allowed by law. In the states of Arizona and North Carolina, the premium charge is 2% of the total manual premium, subject to a minimum premium of $100 per policy. In the states of Connecticut, Florida, Iowa, Maryland, Nebraska and Oregon, the premium charge is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Louisiana, the premium charge is 2% of the total standard premium, subject to a minimum premium of $250 per policy. In the state of Hawaii, the premium charge is $5,509 and determined as follows: The premium charge for this endorsement is 1 % of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Massachusetts, the premium charge is 1 % of the total manual premium. In the state of New York, the premium charge is 2% of the total manual premium, subject to a minimum premium of $250 per policy. In the state of Virgina, the premium charge is 5% ofthe total manual premium, subject to a minimum premium of $250 per policy. Issued by First Liberty Insurance Corporation For attachment to Policy Nci: WA666D066493035 Issued to Swinerton Incorporated Effective Date : 8/1/2025 WC 00 0313 Ed. 04/01/1984 © 1983 National Council on Compensation Insurance. Premium$ Page 1 of 1 Docusign Envelope ID: B8E47CF4-39D0-4BA3-B2EE-99D4B92500B1