Laserfiche WebLink
WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 99 03 76 (00) -- <br />POLICY NUMBER: UB7085Y565 <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />ENDORSEMENT - CALIFORNIA <br />(BLANKET WAIVER) <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not <br />enforce our right against the person or organization named in the Schedule. <br />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in <br />the work described in the Schedule. <br />The additional premium for this endorsement shall be <br />mium otherwise due on such remuneration. <br />Schedule <br />Person or Organization: <br />City of Santa Ana <br />Planning Division <br />Attn: Bill Apple <br />P.O. Box 1988 M-20 <br />Santa Ana, CA 92702 <br />DATE OF ISSUE: 07/28/08 <br />% of the California workers' Compensation pre - <br />Job Description: <br />