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COAST SURVEYING, INC. 1B-2011
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COAST SURVEYING, INC. 1B-2011
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Last modified
6/9/2014 12:48:11 PM
Creation date
5/23/2011 2:00:21 PM
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Contracts
Company Name
COAST SURVEYING, INC.
Contract #
A-2008-096-002
Agency
PUBLIC WORKS
Expiration Date
3/31/2012
Insurance Exp Date
9/18/2012
Destruction Year
2017
Notes
A-2008-096; 01
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TRAVELERS J� WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 99 03 76 (00) — 001 <br />POLICY NUMBER: UB- 7836Y81 -4 <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 3 .0 <br />mium otherwise due on such remuneration. <br />Schedule <br />Person or Organization <br />ANY PERSON OR ORGANIZATION FOR <br />WHICH THE INSURED HAS <br />COMPLETED A WRITTEN AGREEMENT <br />TO PROVIDE THIS WAIVER <br />DATE OF ISSUE: 09 -15 -09 ST ASSIGN: <br />% of the California workers' compensation pre- <br />Job Description <br />
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