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Agmt25 Blacksmith (2048 Broadway)
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Agmt25 Blacksmith (2048 Broadway)
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Last modified
10/16/2025 4:03:19 PM
Creation date
10/16/2025 4:02:22 PM
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Agreement
PROJECT NAME
Outdoor Business Activity License Agreement_9.23.2025
RMP File Number
304.5
Date
9/23/2025
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4 THHREwE AY 3 Page Policy WC/EL Exclusion <br />By DERU <br />Workers Compensation and Employers' Liability Exclusion: <br />The policy's liability coverages are modified to exclude any 1) any claim or damages arising from <br />bodily injury to employees, owners, and officers of your business, and 2) any obligation for which your <br />business (or its insurer) may be held liable under any workers' compensation, disability benefits, or <br />unemployment compensation law or any similar law. <br />All references to workers compensation in the policy must be read in light of this provision, and struck <br />to the extent they are inconsistent. <br />-=/ THREE To Report a Claim or For Questions: Call 1-800-507-4495 or Log On www.threeinsurance.com <br />BY BERK5vIHE HATHAWAY 3PG EXWC 01-1/23 <br />ATTY/AGR.2025.229/Barrel Dog, Inc. dba Blacksmith (2048 Broadway - Blacksmith) (Page 38 of 44) <br />
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