Laserfiche WebLink
TRAVELERS WORKERS COMPENSATION <br /> AND <br /> ONE TOWER SQUARE EMPLOYERS LIABILITY POLICY <br /> HARTFORD CT 06183 <br /> ENDORSEMENT WC 00 00 01 (A) <br /> POLICY NUMBER: UB-3T085335-24-14-G <br /> LISTING OF ENDORSEMENTS <br /> EXTENSION OF INFO PAGE <br /> We agree that the following listed endorsements form a part of this policy on its effective date. <br /> WC 99 06 R4 00 - 006 NOT OF CAN OR NONREN DESIGN PERS OR ORG <br /> WC 99 06 R4 00 - 007 NOT OF CAN OR NONREN DESIGN PERS OR ORG <br /> WC 99 06 R4 00 - 008 NOT OF CAN OR NONREN DESIGN PERS OR ORG <br /> WC 99 06 R6 00 - 001 NOT OF CAN OR MAT TO DESIGN GOV ENTITY <br /> WC 99 06 R6 00 - 002 NOT OF CAN OR MAT TO DESIGN GOV ENTITY <br /> WC 99 06 T7 00 - 001 WI AGREEMNT PROV EARLIER NOTC OF CANCEL <br /> WC 99 06 U9 00 - 001 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 002 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 003 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 004 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 005 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 006 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 007 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 U9 00 - 008 TX NOT CANC OR NONREN TO DESI PER OR ORG <br /> WC 99 06 V4 00 - 001 AMENDED CANC CONDITION ENDT <br /> WC 99 06 V5 00 - 001 AMENDED CANC CONDITION ENDT <br /> WC 99 06 V9 00 - 001 KS AMENDED CANC CONDITION ENDT <br /> WC 00 04 21 E - 001 CATASTROPHE (O/T CERT ACTS OF TERR) ENDT <br /> WC 00 04 21 F - 001 CATASTROPHE (O/T CERT ACTS OF TERR) ENDT <br /> WC 99 04 08 00 - 001 PREMIUM DISCOUNT ENDORSEMENT <br /> WC 99 01 19 C - 001 TRIPRA DISCLOSURE ENDORSEMENT <br /> WC 00 03 02 00 - 001 DESIGNATED WORKPLACES EXCLUSION <br /> WC 00 04 19 00 - 001 PREMIUM DUE DATE ENDORSEMENT <br /> WC 02 04 01 C - 001 AZ ALCOHOL & DRUG FREE WK PLACE PREM END <br /> WC 02 06 01 C - 001 AZ CANCELLATION AND NONRENEWAL ENDT <br /> WC 02 06 03 A - 001 AZ AMENDATORY ENDORSEMENT <br /> WC 04 01 01 A - 001 LONGSHORE & HARBOR WC ACT ENDT - CA <br /> WC 04 03 05 00 - 001 VOL COMP & EMPLOYERS LIAB COV ENDT. <br /> WC 04 03 17 B - 001 EMPLOYEE INSD BY GENERL EMPLYER EXCLUDED <br /> WC 04 03 45 A - 001 COMPREHENSIVE PERSONAL LIAB POL EXCL <br /> WC 04 03 60 B - 001 EMPLOYERS' LIAB COV AMENDATORY ENDT-CA <br /> WC 04 04 21 00 - 001 OPTIONAL PREMIUM INCREASE ENDORSEMENT - CALIFORNIA <br /> WC 04 04 22 00 - 001 CALIFORNIA SHORT-RATE CANCELATION ENDT <br /> DATE OF ISSUE: 05-28-24 ST ASSIGN: PzAPPROVED <br /> By Cynthia Mora at 8:13 am,Oct 31,2024 <br />