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MGT OF AMERICA CONSULTING, LLC
City of Pleasanton
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MGT OF AMERICA CONSULTING, LLC
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Last modified
7/24/2024 3:48:18 PM
Creation date
7/12/2024 1:25:19 PM
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CONTRACTS
Description Type
Professional Services
Contract Type
New
NAME
MGT OF AMERICA CONSULTING, LLC
Contract Record Series
704-05
Munis Contract #
2025090
Contract Expiration
6/30/2029
NOTES
EXPERIENCES IN PROVIDING STATE MANDATED COST CLAIMING SERVICES ON BEHALF OF LOCAL JURISDICTIONS
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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />Countersigned by <br />Authorized Representative <br />WAIVER OF OUR RIGHT TO RECOVER FROM <br />OTHERS ENDORSEMENT - CALIFORNIA <br />4320 W KENNEDY BLVD <br />TAMPA FL 33609 <br />We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our <br />right against the person or organization named in the Schedule. (This agreement applies only to the extent that you <br />perform work under a written contract that requires you to obtain this agreement from us.) <br />You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work <br />described in the Schedule. <br />The additional premium for this endorsement shall be 2 % of the California workers' compensation premium otherwise due <br />on such remuneration. <br />SCHEDULE <br />Person or Organization Job Description <br />Any person or organization for whom you are required by written contract or agreement to obtain this waiver of rights from <br />us <br />Policy Number:10 WB AR7J14 Endorsement Number: <br />Effective Date:05/12/24 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address:TVG-MGT Holdings, LP <br />Form WC 04 03 06 (1) Printed in U.S.A. <br />Process Date:Policy Expiration Date:05/12/25 <br />Docusign Envelope ID: 36EEB99A-F94E-46ED-8637-EB5ACA3AB439
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