Laserfiche WebLink
ENDORSEMENT AGREEMENT <br /> _ATE WAIVER OF SUBROGATION REP D1 <br /> BLANKET BASIS 9255171-24 <br /> FUND RENEWAL <br /> SP <br /> HOME OFFICE 0-27-07-45 <br /> SAN FRANCISCO EFFECTIVE JUNE 5, 2024 AT 12 . 01 A.M. PAGE 1 OF 1 <br /> ALL EFFECTIVE DATES ARE AND EXPIRING JUNE 5, 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 /> ORANGE COUNTY CHILDREN'S THERAPEUT <br /> 2215 N BROADWA'Y FL 1 <br /> SANTA ANA, CA 92706 <br /> WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE <br /> LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL <br /> NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR <br /> ORGANIZATION NAMED IN THE SCHEDULE. <br /> THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU <br /> PERFORM WORK UNDER' A WRITTEN CONTRACT THAT REQUIRES YOU <br /> TO OBTAIN THIS AGREEMENT FROM US. <br /> THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE <br /> 2.00% OF THE TOTAL POLICY PREMIUM. <br /> SCHEDULE <br /> PERSON OR ORGANIZATION JOB DESCRIPTION <br /> ANY PERSON OR ORGANIZATION BLANKET WAIVER OF <br /> FOR WHOM THE NAMED INSURED SUBROGATION <br /> HAS AGREED BY WRITTEN <br /> CONTRACT TO FURNISH THIS <br /> WAIVER <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 /> COEINTERSIGNED AND ISSUED AT SAN FRANCISCO: JUNE 6, 2024 <br /> 2572 AUTFIORIZEf� REPRESENT IVE PRESIDENT AND CEO <br /> SCIF FORM 10217 {REV.4-20181 OLD DP 217 <br />