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<br /> <br /> <br />POLICY NUMBER: <br /> <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />ENDORSEMENT - CALIFORNIA <br />(BLANKET WAIVER) <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. <br />You must maintain payroll records accurately segregating the remuneration of your employees while engaged <br />in the work described in the Schedule. <br />The additional premium for this endorsement shall be % of the California workers' compensation premium <br />otherwise due on such remuneration. <br />Schedule <br />Person or Organization: Job Description: <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />DATE OF ISSUE: <br />WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br /> <br />ENDORSEMENT WC 99 03 76 (00) -- <br />Sandis Civil Engineers <br />UB4027T041 <br />City of Redwood City <br />Redwood City, CA 94063 <br />Community Development Department <br />1017 Middlefield Road <br />Ref: Master On-call Surveying Services. PERSON OR ORGANIZATION <br />CONTINUED:The City of Redwood City, its officers, agents, employees and <br />volunteers. <br />03/03/2016 <br />6.1.E. - Page 20