Laserfiche WebLink
ENDORSEMENT AGREEMENT <br />WAIVER OF SUBROGATION <br />BLANKET BASIS <br />HOME OFFICE SAN FRANCISCO EFFECTIVE JULY 1, 2021 AT 12.01 A.M. <br />ALL EFFECTIVE DATES ARE AND EXPIRING DULY 1, 2022 AT 12.01 A.M. <br />AT 1201 AM PACIFIC <br />STANDARD TIME OR THE <br />TIME INDICATED AT <br />PACIFIC STANDARD TIME <br />CALIFORNIA BARRICADE RENTALS, INC <br />1550 E SAINT GERTRUDE PL <br />SANTA ANA, CA 92705 <br />WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br />LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br />NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br />ORGANIZATION NAMED IN THE SCHEDULE. <br />THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br />PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br />TO OBTAIN THIS AGREEMENT FROM US. <br />THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE <br />2.00% OF THE TOTAL POLICY PREMIUM. <br />I:IM mgifllal <br />PERSON OR ORGANIZATION JOB DESCRIPTION <br />ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br />FOR WHOM THE NAMED INSURED SUBROGATION <br />HAS AGREED BY WRITTEN <br />CONTRACT TO FURNISH THIS <br />WAIVER <br />9063608-21 <br />RENEWAL <br />NA <br />3-67-17-77 <br />PAGE 1 OF <br />NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE <br />OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS <br />POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL RE <br />HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br />LIMITATIONS OF THIS ENDORSEMENT. <br />1 <br />COUNTERSIGNED AND ISSUED AT SAN FRANCISCO- JUKE 8, 2021 lo <br />,ea./v�/mR16 Marug.1 D'M <br />yJ�//� / IIEVIEPPR: <br />6 A13 <br />Z I W4�01 l/�"".Y.^I .1�;�tl/�'i.(/ L' /Oit �ILS:OH <br />Immm <br />AUTHORIZED REPRESENT IIVE PRESIDENT AAO CEOR6k�^""�e"�"'a,.;�,ian� <br />SCIP FORM 10217 IREVJ-20141 <br />