Laserfiche WebLink
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 <br />(Ed. 4.84) <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 WITH WHOM YOU HAVE ENTERED <br />CONTRACT, A CONDITION OF WHICH REQUIRES YOU TO OBTAIN <br />FROM US. THIS ENDORSEMENT DOES NOT APPLY TO BENEFITS <br />OR CLAIMED: <br />1. PURSUANT TO THE WORKERS' COMPENSATION OR EMPLOYERS' <br />OF KENTUCKY, NEW HAMPSHIRE, OR NEW JERSEY; OR, <br />2. BECAUSE OF INJURY OCCURRING BEFORE YOU ENTERED INTO <br />CONTRACT. <br />National Data and Surveying Services <br />DBA All Traffic Data <br />Policy #: P0014-CEl 91653604C <br />Effective Date:09/17/2019 to 09/17/2020 <br />INTO A <br />THIS WAIVER <br />OR DAMAGES PAID <br />LIABILITY LAWS <br />SUCH A <br />REVIEWED & APPROVED <br />By RiSk MuN4QFMENT DivisiON <br />This endorsement changes the policy to which it Is attached and is effective on the date issued unless otherwise stated.. O 6 V ts. i <br />(The Information below is required only when this endorsement is issued subsequent to preparation of the dfi 1 <br />Endorsement Effective Policy No, Endorsement No. ERANciNE f2 VILLAREA <br />Insured <br />Insurance Company <br />WC 00 03 13 <br />(Ed. 4-84) <br />Copyright 19133 Nalional Council on Carnponsalion Insurance <br />Countersigned By <br />Premium $ <br />