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2024-619-E-AMS-Carolina Parks and Play-Seymour Center - Exterior Exercise
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2024-619-E-AMS-Carolina Parks and Play-Seymour Center - Exterior Exercise
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Last modified
11/19/2024 2:35:14 PM
Creation date
11/19/2024 2:34:42 PM
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Contract
Date
10/15/2024
Contract Starting Date
10/15/2024
Contract Ending Date
10/23/2024
Contract Document Type
Contract
Amount
$201,338.00
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Countersigned by <br />Authorized Representative <br />Form WC 00 03 13 Printed in U.S.A. <br />Process Date:08/22/23 Policy Expiration Date:10/01/24 <br />WAIVER OF OUR RIGHT TO RECOVER <br />FROM OTHERS ENDORSEMENT <br />Policy Number:21 WEC AH6HD8 Endorsement Number: <br />Effective Date:10/01/23 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address:Carolina Parks and Play, LLC <br />107 FOUNTAIN BROOK CIR <br />CARY NC 27511 <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. <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />SCHEDULE <br />Any person or organization for whom you are required by contract or agreement to obtain this waiver from us. <br />Endorsement is not applicable in KY, NH, NJ or for any MO construction risk <br />Docusign Envelope ID: FDE0F9FD-AB56-490F-B27D-2843BB8D23A5
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