Laserfiche WebLink
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 <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 anyone not named in the Schedule. <br /> SCHEDULE <br /> Any Person or Organization as required by written contract or agreement that is <br /> executed prior to the loss. <br /> THIS FORM APPLIES ONLY TO THE FOLLOWING STATE(S) IF COVERED BY YOUR POLICY. IF A <br /> STATE IS NOT LISTED BELOW, THIS FORM DOES NOT APPLY IN THAT STATE. <br /> WI <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 10/01/2029 Policy No. PS 9068969 Endorsement No. <br /> Insured TETRA TECH, INC. Premium $ Included <br /> Insurance Company Safety National Casualty Corporation <br /> Countersigned By <br /> WC 00 03 13(04 84) Page 1 of 1 <br /> ©1983 National Council on Compensation Insurance. <br />