Laserfiche WebLink
<br />W~RKERS COMPENSATION AND E~LOYERS LIABILITY INSURANCE POLlC~ <br /> <br />WC000313 <br />(Ed. 4-84) <br /> <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br />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 trom us.) <br /> <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> <br />Schedule <br /> <br />. . i. . ~ ,.--' '_~~) /'.....; <br /> <br />~ yri, <br /> <br />.~;_.j, ..... l<' ;\i., ,. <br /> <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the poiicy.) <br />Endorsement Effective 07/01/07 Policy No. 20WBRMF5433 WI Endorsement No. <br />Insured: TRC Alton Geoscience, Inc. Premium $ INCL <br />Company: Twin City Fire Insurance Company Countersigned By <br /> <br />~~ <br /> <br />WC 00 0313 <br />(Ed. 4-84) <br /> <br />Copyright 198:1 National Council on Compensation Insurance. <br /> <br />AGENT COpy <br />