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WAIVE, R OF Quit <br />ziz ri.rr xo ztz;COV ! . . <br />Wa have tl'e if k 1''IZOU OTI1 <br />elifoire "1,11 to a'ecovet oU• payuieuts fto ' r"NDo 1LS1a>r T <br />ur right rfotm C the person or or a n>, auyoAe liable pol• as <br />cx f.eut that you IJeMoruz w ork under a <br />g wzatiou uatned ui. Uie S vujtuy covered by tGis polic , <br />wxiCieu �uLcact e- dule.(111is a ee Y ,% will not <br />xhis agreement sha that Xe Wres you to ot?la' zneut applies only <br />lluoC o this agroeuleut f p Y to Lho <br />peaate directly ox iudu'ectt t m us.) <br />Y o beue$t any one 110 mined in flee Schedule. <br />Sclzec�,ile <br />Blanket Waiver <br />2820 X. Roxboro Rd_ <br />Durham, NC 27704 <br />Applies to all. jobs as required by <br />written coutr3Ct. <br />Th1s endorsement eltanges Ste policy to which it is allached and Is e{Teclit c on the data issued unless oche <br />(The lnfonnation bdmv is squired only when this endorsemeul is issued subsequuttto re <br />noise slated. <br />lorsement Effecii"; T' P+slion ofUre policy) <br />12/31/2011 . <br />PolicyTdo <br />tred: VN BT(OTTTERS "L UvBING 33EgTTNG CO TNC IfCp 004355 03 > <br />Tindorscrneni 7.To,; ) <br />Carrier <br />Noy 37354 <br />haute Compalty: BUILDERg T'tcmiurn: ' <br />T`'IUTUAL 1NSURANC73 CO. ' <br />C 00 03.13 <br />. A /oK) <br />• Countersigned by <br />tyright 1983 National Council on Campetttation Insurance, ~ <br />!'!h ll�St:RAh't;L' SLRt'ICl•S- !lalAJ <br />Prhls:d nre alae �� zVtp <br />U IYKMAK <br />