Laserfiche WebLink
NAMED INSURED: SIEMENS CORPORATION <br /> POLICY EFFECTIVE: 10-01-24 <br /> AIIIINK <br /> TRAVELERS J WORKERS COMPENSATION <br /> AND <br /> EMPLOYERS LIABILITY POLICY <br /> ENDORSEMENT WC 00 03 13 (00)- <br /> POLICY NUMBER: UB-8P83929A-24-51-X <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 /> DESIGNATED PERSON: <br /> DESIGNATED ORGANIZATION: <br /> ANY PERSON OR ORGANIZATION FOR WHICH THE <br /> INSURED HAS AGREED BY WRITTEN CONTRACT <br /> EXECUTED PRIOR TO LOSS TO FURNISH THIS <br /> WAIVER. <br /> APPROVED <br /> By Cynthia Mora at 4:00 pm, Oct 30, 2024 <br /> DATE OF ISSUE: 09-16-24 ST ASSIGN: <br />