Laserfiche WebLink
TRAVELERS WORKERS COMPENSATION <br />AND <br />ONR TOWER SQUARE EMPLOYERS LIABILITY POLICY <br />HARTFORD, CT 06183 <br />ENDORSEMENT WC 99 03 76 ( A) -- 001 <br />POLICY NUMBER: (XJUB4549T76A17) <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 />Schedule <br />Person or Organization Job Description <br />ANY PERSON OR ORGANIZATION FOR <br />WHICH THE INSURED HAS AGREED <br />BY WRITTEN CONTRACT EXECUTED <br />PRIOR TO LOSS TO FURNISH <br />THIS WAIVER. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise <br />stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of <br />the policy.) <br />Endorsement Effective Policy No. Endorsement No. <br />Insured Premium <br />Insurance Company Countersigned by <br />DATE OF ISSUE: 05-25-16 ST ASSIGN: Page 1 of 1 <br />