Orange County NC Website
37 <br /> WC000313 <br /> WAIVER OF OUR RIGHT TO <br /> RECOVER FROM OTHERS ENDORSEMENT <br /> This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br /> date is indicated below. <br /> (The following"attaching clause"need be completed only when this endorsement is issued subsequent to preparation of the policy.) <br /> This endorsement,effective on at 12:01 A.M.,standard time,forms a part of <br /> (DATE) <br /> Policy No.we s070977 Endorsement No. Premium (if any)$ <br /> of the <br /> (NAME OF INSURANCE COMPANY) <br /> issued to <br /> rn <br /> c <br /> ti <br /> n <br /> rn <br /> 0 <br /> ti <br /> can Authorized Representative <br /> U <br /> 0 <br /> 0 <br /> a <br /> E We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br /> our 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 any one not named in the Schedule. <br /> Schedule <br /> Any party for whom you have agreed via written contract to waive subrogation prior to any loss_ <br /> This waiver is not applicable in any jurisdiction where prohibited by statute or regulation. <br /> Copyright 1983 National Council on Compensation Insurance_ WC UO 03 13 (04184) <br /> INSUREDS COPY <br />