Laserfiche WebLink
G19160B 1197 Page 1 of 1 <br />r-oucr NUMBER .6o176B 6327 <br /> <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br />BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS <br />This endorsement changes the policy to which it is attached. <br />It is agreed that Part One -Workers' Compensation Insurance G- Recovery From Others and Part Two - <br />Employers' Liability Insurance H- Recovery From Others are amended by adding the following: <br />We will not enforce our right to recover against persons or organizations. (This agreement applies only to the <br />extent that you perform work under a written contract that requires you to obtain this agreement from us_) <br />PREMIUM CHARGE <br />The charge will be an amount to which you and we agree that is a percentage of the total standard premium for <br />California exposure. The amount is 2rarara %. <br />c <br />Laura Slit[ Sir:i .- <br />n s?ista nt ?i[y ,'yl ii>r=?..