Laserfiche WebLink
Walker Parking Consultants/Engineers, Inc. <br />AW <br />TRAVELERSJJ <br />Policy Period: 05/23/2016 - 05/23/2017 <br />WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 04 03 06 (01) — 001 <br />POLICY NUMBER: UB4549T76A <br />11 •' +' •. i <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 />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 % OF THE CALIFORNIA WORKERS' <br />COMPENSATION PREMIUM OTHERWISE DUE ON SUCH REMUNERATION. <br />PERSON OR ORGANIZATION JOB DESCRIPTION <br />ANY PERSON OR ORGANIZATION FOR WHICH <br />THE NAMED INSURED HAS AGREED BY <br />WRITTEN CONTRACT LXECUTED PRIORTO <br />LOSS TO FURNISH THIS WAIVER. <br />DATE OFISSUE:o5 -10 -2016 STASSIGN: <br />