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SEDARU FKA ID MODELING, INC.
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Last modified
6/12/2024 12:10:30 PM
Creation date
4/17/2024 2:52:52 PM
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Contracts
Company Name
SEDARU FKA ID MODELING, INC.
Contract #
A-2024-034
Agency
Public Works
Council Approval Date
3/19/2024
Expiration Date
12/31/2024
Insurance Exp Date
9/30/2024
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Workers' Compensation and Employers' Liability Policy <br />Named Insured <br />Endorsement Number <br />VERALTO CORPORATION <br />CIO DANAHER CORPORATION <br />Policy Number <br />2200 PENNSYLVANIA AVE, N.W. #800W <br />Symbol: WLR Number. C70317849 <br />Policy Period <br />Effective Date of Endorsement <br />M30-2023 TO og- 0-2024 <br />09-30-2023 <br />Issued By (Name of Insurance Company) <br />INDEMNITY INS. CO. OF NORTH AMERICA <br />Insert the policy number. The remainder of the Information Is to be completed only when this endorsement Is Issued subsequent to the preparation of the policy. <br />This endorsement changes the pal Icy to which R Is attached and Is effective on the date Issued unless otherwise stated. <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 <br />enforce our right against the person or organization named in the Schedule. This agreement applies only to the <br />extent that 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 any one not named in the Schedule. <br />Schedule <br />ANY PERSON OR ORGANIZATION AGAINST WHOM YOU HAVE AGREED TO WAIVE YOUR <br />RIGHT OF RECOVERY IN A WRITTEN CONTRACT, PROVIDED SUCH CONTRACT WAS <br />EXECUTED PRIOR TO THE DATE OF LOSS. <br />For the states of CA, I IT, T)C refer to state specific endorsements. <br />This endorsement is not applicable in KY, NH, and NJ. <br />The endorsement does not apply to policies in Missouri where the employer is in the construction group of code <br />classifications. According to Section 287.150(6) of the Missouri statutes, a contractual provision purporting to waive <br />subrogation rights against public policy and void where one party to the contract is an employer in the construction <br />group of code classifications. <br />For Kansas, use of this endorsement is limited by the Kansas Fairness in Private Construction Contract Act(K.S.A.. <br />16-1801 through 16-1807 and any amendments thereto) and the Kansas Fairness in Public Construction Contract <br />Act(K.S.A 16-1901 through 16-1908 and any amendments thereto). According to the Acts a provision in a contract <br />for private or public construction purporting to waive subrogation rights for losses or claims covered or paid by <br />liability or workers compensation insurance shall be against public policy and shall be void and unenforceable <br />except that, subject to the Acts, a contract may require waiver of subrogation for losses or claims paid by a <br />consolidated or wrap-up insurance program. <br />Authorized Agent <br />oR,N F RAMougmumtDi slm <br />°K REVIEWED & APPROVED BY. <br />o � <br />Risk Management Specialist <br />WC 00 03 13 (11/05) 0 Copyright 1983-2017 National Council on Compensation Insurance, Inc. All Rights Reserved. <br />
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