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TRC SOLUTIONS, INC. 1A - 2005
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TRC SOLUTIONS, INC. 1A - 2005
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Last modified
5/6/2020 2:14:40 PM
Creation date
7/26/2006 5:19:50 PM
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Contracts
Company Name
TRC Solutions, Inc.
Contract #
A-2004-102-01
Agency
Public Works
Insurance Exp Date
7/1/2011
Notes
Amends A-2004-102
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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT-CALIFORNIA <br />This endorsement changes the policy to which it is attached effective on inception date of the policy unless <br />a different date is indicated below. <br />(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) <br />This endorsement, effective 12:01 AM 07/01/09 <br />Issued to: TRC Solutions, Inc. <br />forms a part of Policy No. 20WN MF5434 A/o <br />$y: Twin City Fire Insurance Company (Hartford) <br />Premium: INCL <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will <br />not enforce our right against the person or organization named in the Schedule. (This agreement applies <br />only to the extent that you perform work under a written contract that requires you to obtain this agreement <br />from us). <br />You must maintain payroll records accurately segregating the remuneration of your employees while <br />engaged in the work described in the Schedule. <br />The additional premium for this endorsement shall be 5% of the California workers' compensation <br />premium otherwise due on such remuneration. <br />Schedule <br />Person or Organization <br />City of Santa Ana <br />20 Civic Center Plaza - Ross Annex (M-36) <br />Santa Ana, CA 92701 <br />Job Description <br />All operations where required by written contract <br />WC 04 03 06 <br />(Ed. 4-84) <br />Countersigned by <br />Authorized Representative
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