Laserfiche WebLink
ENDORSEMENT AGREEMENT <br /> WAIVER OF SUBROGATION <br /> 9221671-24 <br /> STATE RENEWAL <br /> SC <br /> FUND 6-78-43-25 <br /> PAGE 1 <br /> HOME OFFICE <br /> SAN FRANCISCO EFFECTIVE MARCH 18, 2025 AT 12 . 01 A.M. <br /> ALL EFFECTIVE DATES ARE AND EXPIRING NOVEMBER 21 , 2025 AT 12 . 01 A.M. <br /> AT 12:01 AM PACIFIC <br /> STANDARD TIME OR THE <br /> TIME INDICATED AT <br /> PACIFIC STANDARD TIME <br /> TGA TRUCK DRIVING SCHOOL <br /> 1115 S TAYLOR AVE <br /> MONTEBELLO, CA 90640 <br /> ANYTHING IN THIS POLICY TO THE CONTRARY NOTWITHSTANDING, <br /> IT IS AGREED THAT THE STATE COMPENSATION INSURANCE FUND <br /> WAIVES ANY RIGHT OF SUBROGATION AGAINST, <br /> CITY OF SANTA ANA <br /> WHICH MIGHT ARISE BY REASON OF ANY PAYMENT UNDER THIS <br /> POLICY IN CONNECTION WITH WORK PERFORMED BY, <br /> TGA TRUCK DRIVING SCHOOL <br /> IT IS FURTHER AGREED THAT THE INSURED SHALL MAINTAIN <br /> PAYROLL RECORDS ACCURATELY SEGREGATING THE REMUNERATION <br /> OF EMPLOYEES WHILE ENGAGED IN WORK FOR THE ABOVE <br /> EMPLOYER. <br /> IT IS FURTHER AGREED THAT PREMIUM ON THE EARNINGS OF SUCH <br /> EMPLOYEES SHALL BE INCREASED BY 03%. <br /> NOTHING IN THIS ENDORSEMENT SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND <br /> ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS POLICY <br /> OTHER THAN AS ABOVE STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE <br /> HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br /> LIMITATIONS IN THIS ENDORSEMENT. <br /> COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: MARCH 20, 2025 <br /> 2570 <br /> AUTHORIZED REPRESENT IVE PRESIDENT AND CEO <br /> SCIF FORM 10217 (REV.4-2418) OLD DP 217 <br />