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Res 2012-095
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Res 2012-095
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Last modified
9/10/2012 10:22:32 AM
Creation date
8/9/2012 4:03:45 PM
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City Clerk
City Clerk - Document
Resolutions
City Clerk - Type
Approving
Number
2012-95
Date
8/7/2012
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Waiver Of Transfer Of Rights Of Recovery Against Others To Us <br />Policy No. <br />Eff. Date of Pol. <br />Exp. Date of Pol. <br />E ff. Date of End. <br />Aeen" No. <br />Addl. Preen. <br />Return Preen. <br />GLA3994747 <br />10/01/2011 <br />10/01/2012 <br />14345 -000 <br />Incl. <br />This endorsement is issued by the company named in the Declarations. It changes the policy on the effective date listed above <br />at the hour stated in the Declarations. <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Named Insured: Raba Kistner, Inc., etal <br />Address (including ZIP code): P.O. Box 690287 <br />San Antonio, TX 78269 -0287 <br />This endorsement modifies insurance provided under the: <br />Business Auto Coverage Form <br />Truckers Coverage Form <br />Garage Coverage Form <br />Motor Carri er Coverage Form <br />SCHEDULE <br />Name of Person or Organization: <br />ALL PERSONS AND /OR ORGANIZATIONS.THAT ARE REQUIRED BY WRITTEN <br />CONTRACT OR AGREEMENT WITH THE INSURED, EXECUTED PRIOR TO THE <br />ACCIDENT OR LOSS, THAT WAIVER OF SUBROGATION BE PROVIDED UNDER THIS <br />POLICY <br />We Nvaive any right of recovery we may have against the designated person or organization shown in the schedule because of <br />payments we make for injury or damage caused by an "accident" or "los';' resulting from the ownership, maintenance, or use of a <br />covered "auto" for which a Waiver of Subrogation is required in conjunction with work performed by you for the designated <br />person or organization. The waiver applies only to the designated person or organization shown in the schedule. <br />Countersigned: Date: <br />Authorized Representative <br />U -CA -320 -B CW (4/94) <br />Page I of I <br />
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