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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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WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT <br />This endorsement changes the policy to which it is attached effective on inception date of the policy unless a <br />different date is indicated below. <br />(The following " attaching clause" need be completed only when this endorsement is issued subsequent to <br />preparation of the policy). <br />This endorsement, effective 12:01 AM 10/03/2022 forms a part of <br />Policy No. WC 0359-01-931 Issued to ROADSAFE TRAFFIC SYSTEMS, INC <br />By AIU INSURANCE COMPANY <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 any one not named in the Schedule. <br />Schedule <br />Any Person or Organization with whom you have entered into a contract, a condition of which <br />requires you to obtain this waiver from us. This endorsement does not apply to benefits or <br />damages paid or claimed: <br />1. Pursuant to the Workers' Compensation or Employers' Liability Laws of Kentucky, New Hampshire, or <br />New Jersey; or <br />2. Because of Injury Occurring before you entered into such a contract. <br />This form is not applicable in California, Kentucky, New Hampshire, New Jersey, North Dakota, Ohio, Tennessee, <br />Texas, Utah, or Washington. <br />WC 00 03 13 Countersigned by (Ed. 04/84) Authorized Representative <br />
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