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MANAGED CAREER SOLUTIONS, SPC (4)
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MANAGED CAREER SOLUTIONS, SPC (4)
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Last modified
4/23/2021 3:50:55 PM
Creation date
8/12/2020 11:11:24 AM
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Template:
Contracts
Company Name
MANAGED CAREER SOLUTIONS, SPC
Contract #
A-2020-158-01
Agency
FINANCE & MANAGEMENT SERVICES
Council Approval Date
8/4/2020
Expiration Date
10/31/2020
Insurance Exp Date
7/1/2021
Destruction Year
2025
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />WAIVER OF OUR RIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />Policy Number: 72 WEC ADOS03 Endorsement Number: <br />Effective Date: 07/01/20 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address: MANAGED CAREER SOLUTIONS, SPC <br />3333 WILSHIRE BLVD STE 405 <br />LOS ANGELES CA 90010 <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br />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 />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work <br />described in the Schedule. <br />The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due <br />on such remuneration. <br />SCHEDULE <br />Person or Organization <br />Job Description <br />Any person or organization from whom you are required by written contract or agreement to obtain this waiver of rights <br />from us <br />Countersigned by <br />Form WC 04 03 06 (1) Printed in U.S.A. <br />Process Date: 06/03/20 Policy <br />Risk Management Division <br />REVIEWED&APPROVDB�Yp. <br />��iiu-n.sa+ <br />F4,' W Imo. VS411ac <br />Risk Management Analyst <br />
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