Laserfiche WebLink
ENDORSEMENT AGREEMENT <br /> STATE WAIVER OF SUBROGATION <br /> C;QMPFN5ATljQN <br /> INSURANCE BLANKET BASIS 9100741-24 <br /> FUN RENEWAL <br /> NA <br /> HOME OFFICE 1-81-08-39 <br /> SAN FRANCISCO EFFECTIVE OCTOBER 1, 2024 AT 12 .01 A.M. PAGE 1 OF 1 <br /> ALL EFFECTIVE DATES ARE AND EXPIRING OCTOBER 1, 2025 AT 12 . 01 A.M. <br /> AT 12;01 AM PACIFIC <br /> STANDARD TIME OR THE <br /> TIME INDICATED AT <br /> PACIFIC STANDARD TIME <br /> AASCSC <br /> 850 N BIRCH ST <br /> SANTA ANA, CA 92701 <br /> WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br /> LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br /> NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br /> ORGANIZATION NAMED IN THE SCHEDULE. <br /> THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br /> PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU <br /> TO OBTAIN THIS AGREEMENT FROM US. <br /> THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE <br /> 2.00% OF THE TOTAL POLICY PREMIUM. <br /> SCHEDULE <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br /> FOR WHOM THE NAMED INSURED SUBROGATION <br /> HAS AGREED BY WRITTEN <br /> CONTRACT TO FURNISH THIS <br /> WAIVER <br /> NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXPEND <br /> ANY OF THE. TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY <br /> OTHER THAN AS ABOVE STATED. NOT14ING ELSEWHERE IN THIS POLICY SHALL BE <br /> HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br /> LIMITATIONS IN THIS ENDORSEMENT, <br /> COUNTERSIGNED AND ISSUED AT SAN FRANCISCO; <br /> OCTOBER 2, 2024 J/� <br /> Vim. C/C-2--7r•,�' ,//f;'J�N <br /> 2572 AUTHORIZED REPRESENT IVE PRESIDENT AND CEO <br /> SCIF FORM 10217 {REV.4.20181 OLD DP 217 <br />