CTR072894_-_WC_Endorsement__1_.pdf

This document is a Workers Compensation and Employers Liability Insurance Policy endorsement issued by Accredited Surety and Casualty Company, Inc. for Baraka House LLC. The policy is identified with number 1AUIAZ16015005080 and is effective from 3/1/2025, with an endorsement number that includes a waiver of the insurance company's right to recover payments from certain parties.

The endorsement includes a "Blanket Waiver" provision that allows the Named Insured to furnish a waiver for any person or organization with whom they have a written contract. The policy shows a premium of $0.00 and is marked with edition 4-84, indicating it follows specific insurance industry standards. The document provides a mechanism for limiting subrogation rights and potential recovery actions in workers compensation claims, which can be important for managing liability in contractual relationships.