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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 4-84) ©1998 by the Workers’ Compensation Insurance Rating Bureau of California. All rights reserved. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT CALIFORNIA 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.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be _____% of the California workers’ compensation premium otherwise due on such remuneration. Schedule Person or Organization Job Description This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement No. 2 Policy No. Insurance Company RLI Insurance Company All persons or organizations that are party to a contract that requires you to obtain this agreement, provided you executed the contract before the loss. Jobs performed for any person or organization that you have agreed with in a written contract to provide this agreement. PSW0003254Endorsement Effective Insured Kier & Wright Civil Engineers & Surveyors, Inc. All persons or organizations that are party to a contract that All persons or organizations that are party to a contract that requires you to obtain this agreement, provided you executed requires you to obtain this agreement, provided you executed the contract before the loss. Docusign Envelope ID: 1E4E4FCF-7AB2-8687-82B4-D0B680FDBFDB