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DUDEK (4)
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Last modified
8/19/2024 10:49:00 AM
Creation date
5/15/2023 4:39:22 PM
Metadata
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Template:
Contracts
Company Name
https://ecms.santa-ana.org/Forms/LOA
Contract #
A-2023-033-02
Agency
Public Works
Council Approval Date
3/21/2023
Expiration Date
3/20/2026
Insurance Exp Date
8/28/2023
Destruction Year
2031
Notes
For Insurance Exp. Date see Notice of Compliance
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DocuSign Envelope ID: FC7E9346.8A22.4923-I3D05-AA30A0439841 <br />Attachment RS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 <br />WC0146330 Dudek 8/28/20228128/2023 (Ed.4-84) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our 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 />This agreement shall not operate directly or Indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />ANY PERSON OR ORGANIZATION YOU ARE REQUIRED TO WAIVE YOUR RIGHTS OF <br />RECOVERY IN A WRITTEN CONTRACT, AGREEMENT OR PERMIT WITH THE NAMED <br />INSURED. <br />WC 00 0313 <br />(Ed. 4-84) <br />1983 National Council on Compensation Insurance. <br />
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