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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2023_PS-2303001 thru PS-2303500_ - PS-2303312
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Permits & Development - Encroachment(EP)/Driveway(DW) Permits - 2023_PS-2303001 thru PS-2303500_ - PS-2303312
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Last modified
11/6/2023 4:49:30 PM
Creation date
11/6/2023 4:46:55 PM
Metadata
Fields
Template:
Permits_Development
DocName
PS-2303312
Category07
Encroachment(EP)/Driveway(DW) Permits
Year2
2023
Notes2
Mckinley Ave. - Industrial Dr. Intersection at UPRR Tracks
Address
PO Box 1270, Verdi, NV 89439
Application
Roadsafe Traffic Systems
Type
Traffic Control Devices
Supplemental fields
Cross Ref
PWP7110005
Type (2)
Encroachment Permit (EP)
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BLANKET WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br />date is indicated below. <br />(The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy). <br />This endorsement, effective 12:01 AM 10/03/2022 <br />Issued to ROADSAFE TRAFFIC SYSTEMS, INC. <br />By AIU INSURANCE COMPANY <br />forms a part of Policy No. WC 035901930 <br />We have a right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce <br />our right against any person or organization with whom you have a written contract that requires you to obtain this <br />agreement from us, as regards any work you perform for such person or organization. <br />The additional premium for this endorsement shall be 2 % of the total estimated workers compensation premium <br />for this policy. <br />WC 04 03 61 Countersigned by <br />(Ed. 11/90) <br />Authorized Representative <br />
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