Laserfiche WebLink
<br />... <br /> <br />WQRICIJlI COIItIHSA'n~ AND EMPLOYIIW lJA8UT't tNSUWCE POUCY <br /> <br />we DC ClIO. <br /> <br />WAIVER OP OUR RIGHT TO RECOVER FROM OntERS ENDORSEMENT- <br />C...IFORNIA ' <br /> <br />~ MilIt" . to NlCOWII' our pa,menb from M)'OM IIbIIt for -' Injury covered by thll fIGIeY. Wa WIll not enfotCle <br />our rfQht IQIIn8t lie petaan or OI'pnIIIIIIon n~tclln tilt ScNctuIt. ('1'hia ~....rt 'PP" only 10 1he UlII'It th. <br />~ perform work Under a wrIaen llORtl'8llt INit requn.JOU to obtain thia ....._ from us.) <br />You must maintIin pIWfOll nICOtda eccura6e~ ~aIin9 the rwnUl'llN'llllon of your employell Whlll ~ In the <br />WOdC deSOribeclln .. ScNcIullt. <br /> <br />The eddltlonll pqrnUft f<< thie en.....,.1hIIl be I <br />oIlIrwiII'MOft IUCh rerm.nrIlion. <br /> <br />.. d lie CalIomIa WOIMI'I' compen$lIIOn Pl'MlIIII <br /> <br />SCHEDULE <br /> <br />PINON OR 0RCMIZA110N <br /> <br />JOe DElaUPTION <br /> <br />.... UQO'UIID In' <br />COII'I'UCI' <br /> <br />Thia ....... c:hInge$ cne pOlley 10 which II is IIIr.chId IN II efIeotIlIe on 1M daM.... unIIU oIIIrwile..... <br />('IIw ................ ......... ~.... ............... ........ ....11I- to '.......1M...,.) <br /> <br />I!n~ IlilllccM Q8.03.07 ~ No. 0272WOO,84 Endcnnent No. 001 <br /> <br />In8lnd CROSSTOWN ELECTRICAL & DATA, INC. PrlmILm $DICL. <br /> <br />lnannc. CanpIn)' DISCOVER PROPERTY & CASUALTY INSURANCE CO. <br /> <br />Counlttt~ By <br /> <br />. _..,.......... t ~ r ................. __ oIClill1l1lM1l. "........... <br />Fran" we.... ~." W..... ea..... - oft.!...... FCIIIM...... .1-. <br /> <br />~ <br /> <br />,/.' <br /> <br />900/900~ <br /> <br />1VJIaLJ313 Ni01SSOH3 ~099 ~18 9Z9 XVd 10:8 aRL LOOZ/tl/60 <br /> <br />