Laserfiche WebLink
Workers Compensation And Employers Liability Insurance <br />Policy Endorsement <br />1 <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 />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />PER ATTACHED SCHEDULE OF HOLDERS <br />The premium charge for the endorsement is reflected in the Schedule of Operations. <br />All other terms and conditions of the policy remain unchanged. <br />This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, takes <br />effect on the Policy Effective Date of said policy at the hour stated in said policy, unless another <br />effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy <br />unless another expiration date is shown below. <br />Form No: WC 00 03 13 (04-1984) <br />Endorsement Effective Date: <br />ED � AQPRD�ED <br />RE��Ew NP4EMENT DtvtSION <br />By RtSkMA <br />0 <br />Policy No: 6057544415 <br />Policy Effective Date: 04/01/2020 <br />Copyright 1983 National Council on Compensation Insurance, <br />