Orange County NC Website
Browse       Search
<br /> <br />WC 00 03 13 <br />(Ed. 4-84) <br /> 1983 National Council on Compensation Insurance. <br />POLICY NUMBER WC 1040301-09 <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <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 <br />our right against the person or organization named in the Schedule. (This agreement applies only to the extent that <br />you 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 />ALL PERSONS AND/OR ORGANIZATIONS THAT ARE REQUIRED BY WRITTENCONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THEACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS POLICY FOR WORK PERFORMED BY YOU FOR THAT PERSON AND/OR ORGANIZATION <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 />Endorsement Effective 03-01-24 Policy No. WC 1040301-09 Endorsement No. <br />Insured PRECISION WALLS, INC. Premium $ INCL. <br />Insurance Company ZURICH AMERICAN INSURANCE COMPANY <br />Countersigned By <br />Docusign Envelope ID: B61CE74E-980D-45EA-B9F9-C4F195E3CFD2