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Agmt26 Five Guys (801 Middlefield Road)
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Agmt26 Five Guys (801 Middlefield Road)
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Last modified
2/6/2026 4:18:17 PM
Creation date
2/6/2026 4:17:39 PM
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Agreement
PROJECT NAME
Outdoor Brusiness Activity License Agreement
RMP File Number
304.5
Date
2/5/2026
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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - BLANKET <br />WC 99 06 34 <br />• 11 <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 />The additional premium for this endorsement shall be 3% of the total California Workers' Compensation premium <br />otherwise due. <br />Schedule <br />Person or Organization Job Description <br />Any person or organization from whom the All California Operations <br />name insured is required under written <br />contract to furnish this waiver. <br />Policy Number: Insured: <br />Endorsement Effective: Coverage Provided by: Insurance Co. of the West <br />Issue Date: Countersigned by: <br />WC 99 06 34 <br />(Ed. 8-00) <br />ATTY/AGR.2026.016/Kumar Management Corporation (801 Middlefield Rd) (Page 22 of 29) <br />
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