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i4'orlu;rs, Contpensation it Emplo)crs'lJobllit) Po tin <br />1 N "'Ied In±uu'd <br />I °.ndm nre—L\ , I I r <br />TYCO INTERNATIONAL MANAGEMENT COMPANY. <br />9 RLNCET ROAD <br />Symbol: WLR Numbar C485922'72 <br />I 1 PRINCETON NJ OII540 <br />Policy Period <br />Effeedre Dsm oC Endorden�CN ��- <br />10-01 -2015 TO 10 -01 -2016 <br />10 -01 -2015 <br />Issued ny lNan'ic or lnsnranee Compuny9 <br />INDEMNITY INS. CO. OF NORTH AMERICA <br />_ <br />[nx -rt the lmhc5numbar- Ilr.¢mti�R�td Bt nl ninrtrui ±i k�vunt?IUOdnlchvn this vyri is nt�nt i.Ip�u1uC:'ult lint m lh�fwLnSion <br />TEXAS VNAM, "ROh OUR RIGHT TO RECOVER FROM OTHERS ENDORSLNIENT <br />Phis endorsement applies only to tho, insurance provided by the policy beeatiSe Texas is shown in itarn 3.A. of the hitonnation <br />page. <br />%4'e have the right to recover our paytocins from anyone habla for an injury covered by this policy. We will not enforce ourright <br />against the person or organization named in the Schedule, but this waiver applies otily with respect to bodily injury arising out <br />of the operations described in the Schedule, where you arc required by a written contract to obtain this waiver from us. <br />'Phis endorsement shall not operata directly or indirectly to benefit anyone not named in the Schedule. <br />Schedule <br />1. specific Waiver <br />Name of person or organization! <br />( X ) Blanket Waiver <br />Any person or organization for %v hom the Named Insured has agreed by written contract to <br />furnish this vv-aiver. <br />2. Operations: ALL TEXAS OPERATIONS <br />3. Premium: <br />The premium charge for this endorsement shall be _2 -0 percent of the premitnn developed on <br />payroll in connection with work perfomtecl for die above person(s) or organizatioa(s) arising out of the <br />operations described. <br />q. Advance Promium:$0 <br />bA'C 42 0 0 -1 ,0. (1'00) flit. in U.S_A. <br />