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Agmt05 California Public Entity
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Agmt05 California Public Entity
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Entry Properties
Last modified
4/16/2007 2:42:33 PM
Creation date
6/21/2005 10:42:40 AM
Metadata
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Template:
Agreement
Contractor Name
California Public Entity Insurance Authority
PROJECT NAME
worker's compensation excess insurance
RMP File Number
304
Date
6/16/2005
MO Ref
05-104
Box
6360
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<br />ENDORSEMENT NO. U1 <br /> <br />CSAC EXCESS INSURANCE AUTHORITY <br />SPECIFIC EXCESS WORKERS' COMPENSATION <br />LONGSHOREMEN'S & HARBOR WORKERS' COMPENSATION ACT <br />AMENDATORY ENDORSEMENT <br /> <br />It is understood and agreed that the Merrorandum of Coverage is amended as follows: <br /> <br />It is agreed that the Insuring Agreements of theMemorandum shall also apply to Loss paid <br />by the Covered Party because of Liability imposed by the Longshoremen's and Harbor <br />Workers' Compensation Act (33 use Sectbns 901-950). <br /> <br />As respects this endorsement, Loss shall be limited (by amount and time of payment) to the <br />benefits which would be available under the Workers' Compensation Act of the state where <br />the injured Employee is normally employed, if that law appliEd. <br /> <br />It is further agreed that nothing herein shall act to increase the Authority's Limit of Indemnity. <br /> <br />This endorsement is part of the Memorandum of Coverage and takes effect on the effective <br />date of the Memorandum of Coverage unless another effective date is shown below. All <br />other terms and conditions remain unchanged. <br /> <br />Effective Date: July 1. 2004 <br /> <br />Memorandum No.: CPEIA 04 EWe-55 <br /> <br />Issued to: City of Lompoc <br /> <br />Date: December 6.2004 <br /> <br /> <br />.. .. --~" . ---" ..-. <br />
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