WORKERS’ COMPENSATION AND EMPLOYERS’ LIABILIY …



WORKERS’ COMPENSATION AND EMPLOYERS’ LIABILIY INSURANCE POLICYWC 00 03 13WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENTThis endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different date is indicated below.(The following “attaching clause” need be completed only when this endorsement is issued subsequent to preparation of the policy.)This endorsement, effective on XXXX atXX:XX standard time, forms a part of (DATE)Policy No. 00000 Insurance Company Must Be Listed(NAME OF INSURANCE COMPANY)Issued to XYZ Vendor Premium (if any) IncludedNeed Signature Here Authorized RepresentativeWe have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule.This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.ScheduleWhere required by contract or agreement (except where not permitted by law).Springboard Management, LLCSpringboard Housing, LLC FORMDROPDOWN FORMDROPDOWN ................
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