Laserfiche WebLink
ENDORSEMENT AGREEMENT <br />WAIVER OF SUBROGATION <br />BLANKET BASIS <br />HOME EFFECTIVE JULY 1, 2021 AT 12.01 A.M. <br />FRANCFRANCISC0 ALLEFFECTIVE DATESARE AND EXPIRING JULY 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 />SCHEDULE <br />PERSON OR ORGANIZATION <br />ANY PERSON OR ORGANIZATION <br />FOR WHOM THE NAMED INSURED <br />HAS AGREED BY WRITTEN <br />CONTRACT TO FURNISH THIS <br />WAIVER <br />JOB DESCRIPTION <br />BLANKET WAIVER OF <br />SUBROGATION <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 BE <br />HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br />LIMITATIONS OF THIS ENDORSEMENT. <br />1 <br />COUNTERSIGNED AND ISSUED AyTSSAAfNFRFRANCISCO-- 11UNE 8, 2021 <br />YfNNCRMv�cgemRovEc) r. <br />,n REv�EwEo 6 ARrRovm Br. <br />AUTHORIZED REPRESENT IVE PRESIDENT ANO CE °I, INS', A«j:sA�w�dR <br />SCiF FORM 102SY IREV_7-10141 <br />�. <br />01 <br />Risk Management Specialist yi <br />