Orange County NC Website
Browse       Search
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 0313 <br /> (Ed.4-84) <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy.We will not enforce our <br /> right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br /> perform work under a written contract that requires you to obtain this agreement from us.) <br /> This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> Schedule <br /> ANY PERSON OR ORGANIZATION ON WHOSE BEHALF YOU ARE REQUIRED TO OBTAIN <br /> THIS WAIVER OF OUR RIGHT TO RECOVER FROM UNDER A WRITTEN CONTRACT OR <br /> AGREEMENT. <br /> N <br /> O <br /> O <br /> r <br /> n <br /> 0 <br /> rn <br /> 0 <br /> N <br /> n <br /> 0 <br /> °o <br /> N <br /> O <br /> O <br /> d <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br /> Policy WC2093007771 <br /> Endorsement Effective No. Endorsement No. <br /> °— Insured Buxton Company Premium$ <br /> Insurance Company Countersigned by <br /> WC 00 0313 <br /> (Ed.4-84) Copyright 1983 National Council on Compensation Insurance. <br />