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AESCO INC. (2)-2011
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AESCO INC. (2)-2011
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Last modified
9/4/2018 11:19:58 AM
Creation date
12/2/2011 10:52:38 AM
Metadata
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Template:
Contracts
Company Name
AESCO INC.
Contract #
A-2011-057-01
Agency
PUBLIC WORKS
Insurance Exp Date
4/11/2019
Destruction Year
0
Notes
A-2011-057
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AESCO A-201 1-057-01 REVIEWED BY: EUNICE HEREDIA (PG 6 OF 7) <br />THIS ENDORSEMENT CHANGES TFIE POLICY. PLEASE READ ITCAREFULLY. <br />WAIVER OF OUR R1GH,rT0 RECOVER FROM <br />OTHERSENDORSEMEN I- - CALIFORNIA <br />POfty NUrnber; '72 VIEC IJJ67I10 Endorsement Number: <br />Effecflvc-Date. 04/1.1/15 Fffective hour is the sarne Lis stated an the Inforniabon Page of the policy. <br />Named Insured and Address: AES'CO TNC' <br />IT782 GEORGE,rmqb) LINT <br />HA-QqT1NG,T(-)N BEAC, CA 92647 <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We wih not <br />enforce our right against the person or organization narned in the Schedule. (This agreement applies only to the <br />extent that you perform work Linder a written contract that requires you to obtain this agreement frorn us,) <br />You must maintain payroill records accurately segregating the remuneration Of Your employees while engaged in <br />the work described in the Schedule <br />The additional prernium for this endorsement shah' be <br />premium otherwise due on such remuneration. <br />PdNY OR ORGA1VIZA-11ON <br />FROM WHOM YOU ARE REQUIRE1, <br />BY NRI'712N CONITP—z�'I"J' OR <br />�-\GREEMRNT '10 OBTTLILN THIS <br />1�,IAIVI-�R OF R'1G-HTE, PROM US-. <br />SCHEDULE <br />0 (j i 7 1[ F, �-S tr <br />ied by <br />2 % of the California workers' compensation <br />,Job Description <br />AS 1REQ1jTRED BY NRI TTEN <br />CONTRACT, <br />Al-iihorized Rapresenr aflvH <br />Forrn WC 04 03 06 Printed in U,S.A. <br />Process Date, ti i PoHcy Expirad: on, Date: 0 4 / 1 1 <br />
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