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06/26/12
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06/26/12
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Last modified
7/18/2025 11:15:47 AM
Creation date
6/22/2012 1:49:27 PM
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Meetings
Meeting Document Type
Agenda
Document Title
Housing & Redevelopment Authority
Document Date
06/26/2012
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WORKERS' COMPENSATION AND EMPLOYERS' LtAEILITY INSURANCE POLICY WC 00 03 13 <br />(Ed. 4-84) <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />We have the: right to recover pur 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 Schedule. (This agreement applies only to the <br />extent thatyou perform work under a.writteri' contract that requires you to obtairr.this agreement from us) <br />•This.agreement shalt not;operate directly or indirectly to benefit anyone not named in the schedule: <br />1 MN' <br />• Schedule. <br />AZL PERSONS) OR ORGANIZATION(S) AS <br />nEoUIREt:9y WRITTEN.CONTRACT <br />1.00(S) A&SPCIP1 0 IN • <br />WRITTEN CONTRACT , <br />This endorsement changes the policy to which it is attached effective on the date issued unless otherwise indicated, <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy,) • <br />Endorsement Effective Policy No. <br />insured <br />insurance Company <br />SECURA INSURANCE, <br />A Mutual .Company <br />WC 00 0313 <br />(Ed. 4 84) <br />CJ 1983 National pound' on Compensallon.tnsurance <br />Countersigned by <br />Endorsement No. 000 <br />Premium $ <br />
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