Laserfiche WebLink
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 34 <br />(Ed. 8 -00) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET <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. (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 />The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium <br />otherwise due. <br />Person or Organization <br />ANY PERSON OR ORGANIZATION <br />FOR WHOM THE NAMED INSURED IS <br />REQUIRED UNDER WRITTEN <br />CONTRACT TO FURNISH THIS <br />WAIVER. <br />Policy Number: WSD 5023745 00 <br />Endorsement Effective: 4/1/13 <br />Issue Date: 5/16/13 <br />WC 99 06 34 <br />(Ed. 8.00) <br />Schedule <br />Job Description <br />RE: ALL CALIFORNIA OPERATIONS. <br />r <br />ROVED AS'�0 E' 01 r <br />r� <br />Laura A. Rossini <br />s ;r.atti COV Attorney <br />Insured: MetroPro Road Services, Inc. <br />Coverage Provided by: Insurance Company of the West <br />Countersigned by: <br />