iWATER, INC. (2) - Laserfiche WebLink

Home Browse Search

WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 66 (Ed.07-18) ENDORSEMENT AGREEMENT LIMITING AND RESTRICTING THIS INSURANCE PROFESSIONAL CORPORATION COVERAGE/EXCLUSION-CALIFORNIA If the employer named in Item 1 of the Information Page is a professional corporation,as defined in Section 13401 of the Corporations Code,this policy applies to all owners who are practitioners rendering the professional services for which the professional corporation is organized,as employees,except those excluded below who state that he or she is covered by a health insurance policy or a health care service plan. If the employer named in Item 1 of the Information Page is a professional corporation,as defined in Section 13401 of the Corporations Code,this policy applies to the owner who is the sole shareholder of the private professional corporation, as an employee,except if excluded below. The insurance under this policy is limited as follows:It is AGREED that,anything in this policy to the contrary notwithstanding,this policy DOES NOT INSURE: Owners/Trustees Excluded Title DONALD RHODES EXECUTIVE OFFICER JULIE RHODES EXECUTIVE OFFICER APPROVED By Cynthia Mora at 10:37 am, Dec 04, 2024 Nothing in this endorsement shall be held to vary,alter,waive or extend any of the terms,conditions,agreements,or limitations of this policy other than as above stated.Nothing elsewhere in this policy shall be held to vary,alter,waive or limit the terms,conditions, agreements or limitations in this endorsement. It is further agreed that remuneration when used as a premium basisforsuch insurance as isafforded bythis policyshall not include the remuneration of any person excluded from coverage in accordance with the foregoing. FAILURE TO SECURE THE PAYMENT OF FULL COMPENSATION BENEFITS FOR ALL EMPLOYEES AS REQUIRED BY LABOR CODE SECTION 3700 IS A VIOLATION OF LAW AND MAY SUBJECT THE EMPLOYER TO THE IMPOSITION OF A WORK STOP ORDER,LARGE FINES,AND OTHER SUBSTANTIAL PENALTIES(Labor Code Section 3710.1,et seq.). 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 Effective Policy No. Endorsement No. Insured Insurance Company Countersigned by WC 0403 66 Page 1 of 1 (Ed.7-18) ©2017 by the Workers Compensation Insurance Rating Bureau of California.All rights reserved. 93-6454