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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 <br />policy.) <br />Insured <br />APT Advanced Polymer Technology Corporation <br />Policy No. <br />WC E658736 05 <br />Company <br />Great American Alliance Insurance Company <br />Effective Date Premium <br />$ <br />Endorsement No. <br />Authorized <br />Representative Aon Risk Services Central Inc <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 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 anyone not named in the Schedule. <br />Schedule <br />Any Person or Organization for whom the insured has agreed by written contract to furnish this waiver for all states listed <br />in Item 3A of the Information Page. <br />© 1983 National Council on Compensation Insurance. <br />WC 00 03 13 (Ed. 04-84) <br />WC 00 03 13 (Ed. 04-84) <br />(Page 1 of 2) <br />R * SW * 01/07/2026 * WC E658736 05 00 Great American Alliance Insurance Company <br />*D/B* 894082973 107288 <br />Docusign Envelope ID: DAE6D8AF-BF69-4C23-B861-58AA0D8C544C