Laserfiche WebLink
I <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />TEXAS WAIVER OF OUR RIGHT TO <br />RECOVER FROM OTHERS ENDORSEMENT <br />Policy Number:59 WE AL3MXU Endorsement Number: <br />Effective Date: 0610112022 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address: <br />IEC Corporation <br />16485 Laguna Canyon Rd #300 <br />Irvine, CA 92618 <br />This endorsement applies only to the insurance of the operations described in the Schedule where <br />provided by the policy because Texas is shown in you are required by a written contract to obtain this <br />Item 3.A. of the Information Page. waiver from us. <br />We have the right to recover our payments from This endorsement shall not operate directly or <br />anyone liable for an injury covered by this policy. We indirectly to benefit anyone not named in the <br />will not enforce our right against the person or Schedule. <br />organization named in the Schedule, but this waiver The premium for this endorsement is shown in the <br />applies only with respect to bodily injury arising out Schedule. <br />Schedule <br />1. ( ) Special Waiver <br />Name of person or organization <br />(x) Blanket Waiver <br />Any person or organization for whom the Named Insured has agreed by written contract to furnish <br />this waiver. <br />2. Operations: <br />3. Premium: <br />The premium charge for this endorsement shall be percent of the premium developed on payroll <br />in connection with work performed for the above person(s) or organization(s) arising out of the operations <br />described. <br />4. Advance Premium: <br />Form WC 42 03 04 B Printed in U.S.A. <br />Process Date: <br />wa�Mix�, <br />> %RFne &APPROV Hr <br />a T eG <br />Policy Expiration D ISO, <br />,� <br />PoskManr9.ent LMAnatyft <br />