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WEBER WATER RESOURCES CA, LLC (2)
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WEBER WATER RESOURCES CA, LLC (2)
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Last modified
5/5/2025 10:08:43 AM
Creation date
9/19/2024 1:40:41 PM
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Contracts
Company Name
WEBER WATER RESOURCES CA, LLC
Contract #
A-2021-161-03A
Agency
Public Works
Council Approval Date
8/17/2021
Expiration Date
8/31/2026
Insurance Exp Date
5/1/2026
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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 <br /> (Ed. 04-84) <br /> WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA <br /> We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right <br /> against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work <br /> under a written contract that requires you to obtain this agreement from us.) <br /> You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work <br /> described in the Schedule. <br /> The additional premium for this endorsement shall be 2 % of the California workers'compensation premium otherwise due <br /> on such remuneration. <br /> Schedule <br /> Person or Organization Job Description <br /> Any person or organization where waiver of our right to recover is permitted by <br /> law and is required by written contract provided such contract was executed <br /> prior to date of loss <br /> Notes: <br /> 1. This endorsement may be used to waive the company's right of subrogation against named third parties who may be <br /> responsible for an injury. <br /> 2. The sentence in ( ) is optional with the company. It limits the endorsement to apply only to specific jobs of the insured, <br /> and only to the extent that the insured is required to obtain this waiver. <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 05/01/2025 Policy No. ZAWC11078000 Endorsement No. <br /> Insured Weber Water Resources CA,LLC Insurance Company <br /> Countersigned By <br /> ©Workers'Compensation Insurance Rating Bureau of California. <br />
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