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2026-116-E-AMS-Brown Brothers Plumbing & Heating Co.-Library_Repair Fire Line at Backflow
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2026-116-E-AMS-Brown Brothers Plumbing & Heating Co.-Library_Repair Fire Line at Backflow
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Last modified
4/9/2026 9:39:33 AM
Creation date
4/9/2026 9:32:50 AM
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Contract
Date
3/2/2026
Contract Starting Date
3/2/2026
Contract Ending Date
3/6/2026
Contract Document Type
Contract
Amount
$14,726.00
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Schedule <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 Policy No. Endorsement No. <br />Insured Premium $ <br />Insurance Company Countersigned by <br />WC 00 03 13 <br />(Ed. 4-84)Copyright 1983 National Council on Compensation Insurance. <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 <br />not enforce our right against the person or organization named in the Schedule. (This agreement applies <br />only to the extent that you perform work under a written contract that requires you to obtain this <br />agreement from us.) <br />This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br />ANY PERSON OR ORGANIZATION THAT IS REQUIRED BY WRITTEN CONTRACT EXCEPT <br />OPERATIONS RELATED TO WRAP-UPS. BUILDERS MUTUAL INSURANCE COMPANY INC IS NOT A <br />CONTRIBUTOR TO ANY WRAP-UP PROJECT. <br />Brown Brothers Plumbing & Heating Co., Inc. <br />Builders Mutual Insurance Co. <br />12/31/2025 AWC 0000022 17 <br />Docusign Envelope ID: AC1CD288-4733-4BAB-B895-FE5CCF37576B
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