2023-07-26 CTR065774 SWCA GAUWP.pdf
PDF 2 MB Posted
- Attached to
- Master Agreement AZ|CTR065774
- Contract number
- CTR065774
- Issued by
- Arizona
About this file
The document is a comprehensive insurance policy certificate for SWCA, Incorporated (dba SWCA Environmental Consultants), issued by multiple insurance carriers including Greenwich Insurance Company, XL Specialty Insurance Company, and Steadfast Insurance Company. The policy covers various liability types including commercial general liability, automobile liability, umbrella liability, workers' compensation, environmental liability, and professional liability. The certificate is issued to SWCA, located in Phoenix, Arizona, with the Arizona Department of Environmental Quality listed as the certificate holder, and it is effective from July 26, 2022 to July 26, 2023.
The insurance policy provides extensive coverage across multiple domains, with significant liability limits. The commercial general liability coverage has a $1,000,000 each occurrence limit and a $2,000,000 general aggregate limit. Automobile liability is also set at $1,000,000, with an umbrella liability of $5,000,000. Workers' compensation follows statutory requirements, and environmental/professional liability is set at $15,000,000 per claim with a $15,000,000 aggregate limit. The policy includes additional insured provisions for the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees. The coverage is specifically related to a solicitation (BPM005278) for TMDL and Watershed Modeling and Application, with various endorsements providing primary and non-contributory insurance status and waivers of subrogation.
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INSR ADDL SUBR
LTR INSR WVD
DATE (MM/DD/YYYY)
PRODUCER CONTACT
NAME:
FAXPHONE
(A/C, No):(A/C, No, Ext):
ADDRESS:
INSURER A :
INSURED INSURER B :
INSURER C :
INSURER D :
INSURER E :
INSURER F :
POLICY NUMBER
POLICY EFF POLICY EXP
TYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY)
COMMERCIAL GENERAL LIABILITY
AUTOMOBILE LIABILITY
UMBRELLA LIAB
EXCESS LIAB
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
AUTHORIZED REPRESENTATIVE
INSURER(S) AFFORDING COVERAGE NAIC #
Y / N
N / A (Mandatory in NH)
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
EACH OCCURRENCE $
DAMAGE TO RENTED
$PREMISES (Ea occurrence)CLAIMS-MADE OCCUR
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG $
PRO-
OTHER:
LOCJECT
COMBINED SINGLE LIMIT
$(Ea accident)
BODILY INJURY (Per person) $ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS
AUTOS ONLY
HIRED PROPERTY DAMAGE $
AUTOS ONLY (Per accident)
OCCUR EACH OCCURRENCE $
CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below
POLICY
NON-OWNED
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s).
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
CERTIFICATE HOLDER CANCELLATION
© 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE
Greenwich Insurance Company
XL Specialty Insurance Company
Steadfast Insurance Company
5/22/2023
USI Insurance Services, LLC 2375 E.Camelback Rd. Suite 250 Phoenix, AZ 85016
Misty Klemme 602-749-4112 misty.klemme@usi.com
SWCA, Incorporated dba SWCA Environmental Consultants 20 East Thomas Road Suite 1700 Phoenix, AZ 85012
22322 37885 26387
A X X
X BI/PD Ded: 10,000
X
X X GEC001910417 07/26/2022 07/26/2023 1,000,000
300,000 10,000 1,000,000 2,000,000 2,000,000
A X
X X
X X AEC001910217 07/26/2022 07/26/2023 1,000,000
B X
X
X 10,000
X X UEC001910317 07/26/2022 07/26/2023 5,000,000
B
N
X WEC001910617 07/26/2022 07/26/2023 X
1,000,000
1,000,000 1,000,000
C Enviro. Liab Prof Contractors Poll Claims Made
PEC992416900 07/26/2022 07/26/2023 $15,000,000 Each Claim $15,000,000 Aggregate $100,000 Ded.
Professional Liability and Contractors Pollution Retro Date: 02/28/1990 - Policy Aggregate $5,000,000/$5,000,000; Professional and Job site Retro Date: 02/28/1990 $2,000,000/$2,000,000 *Various Other Coverages/Limits Retro Dates Apply.
The General Liability, Automobile Liability, Umbrella/Excess Liability and Pollution Liability policies (See Attached Descriptions)
Arizona Department of Environmental Quality 1110 W. Washington St.
Phoenix, AZ 85007
#S40131591/M37820154
SWCAINCClient#: 1520486
MYKJD
#S40131591/M37820154
SAGITTA 25.3 (2016/03)
DESCRIPTIONS (Continued from Page 1) include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder only when there is a written contract that requires such status, and only with regards to work performed on behalf of the Named Insured. The General Liability, Automobile Liability, Umbrella/Excess Liability and Pollution Liability policies contain a special endorsement with "Primary and Noncontributory" wording, when required by written contract. The General Liability, Automobile Liability, Umbrella/Excess Liability, Professional Liability, Pollution Liability and Workers Compensation policies provide a Waiver of Subrogation when required by written contract. The General Liability, Automobile Liability and Workers Compensation Policies extend from the underlying to the Umbrella/Excess policy.
Excess Liability limits are in excess of Automobile Liability, General Liability and Workers Compensation.
30 Day Notice of Cancellation to Certificate Holder per attached forms.
RE: DOS: Solicitation No. BPM005278 TMDL and Watershed Modeling and Application Additional Insured Includes: The State of Arizona, and its departments, agencies, boards, commissions, universities, officers, officials, agents and employees
#S40131591/M37820154
POLICY NUMBER: COMMERCIAL GENERAL LIABILITY
CG 20 26 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 26 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
ADDITIONAL INSURED – DESIGNATED
PERSON OR ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s):
Any person or organization where required by written contract provided that such contract was executed prior to the date of loss.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf:
1. In the performance of your ongoing operations;
or
2. In connection with your premises owned by or rented to you.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of insurance;
whichever is less.
This endorsement shall not increase the applicable limits of insurance.
jenn.decker Typewritten text
GEC001910417
CG 20 10 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 2
ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – SCHEDULED PERSON OR
ORGANIZATION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations
Any person or organization where required by written contract provided that such contract was executed prior to the date of loss.
All Locations as required per written contract.
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by:
1. Your acts or omissions; or
2. The acts or omissions of those acting on your behalf;
in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above.
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply:
This insurance does not apply to "bodily injury" or "property damage" occurring after:
1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or
2. That portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project.
jenn.decker
CG 20 10 12 19 © Insurance Services Office, Inc., 2018 Page 2 of 2
C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of insurance;
whichever is less.
This endorsement shall not increase the applicable limits of insurance.
CG 20 37 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 37 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
ADDITIONAL INSURED – OWNERS, LESSEES OR
CONTRACTORS – COMPLETED OPERATIONS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
SCHEDULE
Name Of Additional Insured Person(s) Or Organization(s) Location And Description Of Completed Operations
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury" or "property damage" caused, in whole or in part, by "your work" at the location designated and described in the Schedule of this endorsement performed for that additional insured and included in the "products-completed operations hazard".
However:
1. The insurance afforded to such additional insured only applies to the extent permitted by law; and
2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:
If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement; or
2. Available under the applicable limits of insurance;
whichever is less.
This endorsement shall not increase the applicable limits of insurance.
jenn.decker Typewritten text
GEC001910417
jenn.decker
When Required by written contract
COMMERCIAL GENERAL LIABILITY
CG 20 34 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 20 34 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
ADDITIONAL INSURED – LESSOR OF LEASED
EQUIPMENT – AUTOMATIC STATUS WHEN
REQUIRED IN LEASE AGREEMENT WITH YOU
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
A. Section II – Who Is An Insured is amended to include as an additional insured any person(s) or organization(s) from whom you lease equipment when you and such person(s) or organization(s) have agreed in writing in a contract or agreement that such person(s) or organization(s) be added as an additional insured on your policy. Such person(s) or organization(s) is an insured only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such person(s) or organization(s).
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law;
and
2. Will not be broader than that which you are required by the contract or agreement to provide for such additional insured.
A person's or organization's status as an additional insured under this endorsement ends when their contract or agreement with you for such leased equipment ends.
B. With respect to the insurance afforded to these additional insureds, this insurance does not apply to any "occurrence" which takes place after the equipment lease expires.
C. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance:
The most we will pay on behalf of the additional insured is the amount of insurance:
1. Required by the contract or agreement you have entered into with the additional insured;
or
2. Available under the applicable limits of insurance;
whichever is less.
This endorsement shall not increase the applicable limits of insurance.
jenn.decker
Policy Number: GEC001910417
XIL 424 0605
©, 2005, XL America, Inc.
ENDORSEMENT #
This endorsement, effective 12:01 a.m., , forms a part of
Policy No. issued to SWCA, Inc. DBA: SWCA ENVIRONMENTAL CONSULTANTS by Greenwich Insurance Company.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY INSURANCE CLAUSE ENDORSEMENT
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS COVERAGE PART
It is agreed that to the extent that insurance is afforded to any Additional Insured under this policy, this insurance shall apply as primary and not contributing with any insurance carried by such Additional Insured, as required by written contract.
All other terms and conditions of this policy remain unchanged.
jenn.decker Typewritten text 07/26/2022 jenn.decker
CG 25 03 05 09
CG 25 03 05 09 © Insurance Services Office, Inc., 2008 Page 1 of 2
DESIGNATED CONSTRUCTION PROJECT(S)
GENERAL AGGREGATE LIMIT
COMMERCIAL GENERAL LIABILITY COVERAGE PART
Designated Construction Project(s):
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. For all sums which the insured becomes legally obligated to pay as damages caused by "occur-rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which can be attributed only to ongoing operations at a single designated construction project shown in the Schedule above:
1. A separate Designated Construction Project General Aggregate Limit applies to each des-ignated construction project, and that limit is equal to the amount of the General Aggregate Limit shown in the Declarations.
2. The Designated Construction Project General Aggregate Limit is the most we will pay for the sum of all damages under Coverage A, ex-cept damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard", and for medi-cal expenses under Coverage C regardless of the number of:
a. Insureds;
b. Claims made or "suits" brought; or
c. Persons or organizations making claims or bringing "suits".
3. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the Designated Con-struction Project General Aggregate Limit for that designated construction project. Such payments shall not reduce the General Ag-gregate Limit shown in the Declarations nor shall they reduce any other Designated Con-struction Project General Aggregate Limit for any other designated construction project shown in the Schedule above.
4. The limits shown in the Declarations for Each Occurrence, Damage To Premises Rented To You and Medical Expense continue to apply.
However, instead of being subject to the General Aggregate Limit shown in the Decla-rations, such limits will be subject to the appli-cable Designated Construction Project Gen-eral Aggregate Limit.
Each of your projects away from premises owned by or rented to you- when required by written contract jenn.decker
Page 2 of 2 © Insurance Services Office, Inc., 2008 CG 25 03 05 09
B. For all sums which the insured becomes legally obligated to pay as damages caused by "occur-rences" under Section I – Coverage A, and for all medical expenses caused by accidents under Section I – Coverage C, which cannot be attrib-uted only to ongoing operations at a single des-ignated construction project shown in the Sched-ule above:
1. Any payments made under Coverage A for damages or under Coverage C for medical expenses shall reduce the amount available under the General Aggregate Limit or the Products-completed Operations Aggregate Limit, whichever is applicable; and
2. Such payments shall not reduce any Desig-nated Construction Project General Aggre-gate Limit.
C. When coverage for liability arising out of the "products-completed operations hazard" is pro-vided, any payments for damages because of "bodily injury" or "property damage" included in the "products-completed operations hazard" will reduce the Products-completed Operations Ag-gregate Limit, and not reduce the General Ag-gregate Limit nor the Designated Construction Project General Aggregate Limit.
D. If the applicable designated construction project has been abandoned, delayed, or abandoned and then restarted, or if the authorized contract-ing parties deviate from plans, blueprints, de-signs, specifications or timetables, the project will still be deemed to be the same construction pro-ject.
E. The provisions of Section III – Limits Of Insur-ance not otherwise modified by this endorsement shall continue to apply as stipulated.
CG 24 04 12 19
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
ELECTRONIC DATA LIABILITY COVERAGE PART
LIQUOR LIABILITY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART DESIGNATED SITES
POLLUTION LIABILITY LIMITED COVERAGE PART DESIGNATED SITES
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
RAILROAD PROTECTIVE LIABILITY COVERAGE PART
UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS
SCHEDULE
Name Of Person(s) Or Organization(s):
Any person or organization where required by written contract provided that such contract was executed prior to the date of loss (as permissable by law)
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The following is added to Paragraph 8. Transfer Of Rights Of Recovery Against Others To Us of Section IV – Conditions:
We waive any right of recovery against the person(s) or organization(s) shown in the Schedule above because of payments we make under this Coverage Part. Such waiver by us applies only to the extent that the insured has waived its right of recovery against such person(s) or organization(s) prior to loss. This endorsement applies only to the person(s) or organization(s) shown in the Schedule above.
jenn.decker
ENDORSEMENT #
This endorsement, effective 12:01 a.m., forms a part of
Policy No. issued to SWCA, Inc. DBA: SWCA ENVIRONMENTAL CONSULTANTS by Greenwich Insurance Company.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT
In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below:
Name of Person(s) or Entity(ies) Mailing Address:
Number of Days
Advanced Notice of Cancellation:
ANY PERSON(S) OR ENTITY(IES)
REQUIRING BY WRITTEN CONTRACT
THAT THE NAMED INSURED PROVIDE
ADVANCED WRITTEN NOTICE OF
CANCELLATION. THE PERSON OR
ENTITY MUST BE LISTED ON A
SPREADSHEET FROM THE BROKER
THAT INCLUDES THE PERSON'S OR
ENTITY'S NAME AND A VALID MAILING
ADDRESS. THIS SPREADSHEET MUST
BE RECEIVED BY THE COMPANY
WITHIN FIVE DAYS OF THE COMPANY'S
REQUEST TO THE BROKER.
OTHERWISE, THE COMPANY WILL BEAR
NO RESPONSIBILITY FOR SUCH
ADVANCED WRITTEN NOTICE OF
CANCELLATION
REFER TO SPREADSHEET PROVIDED 30
IXI 405 0910
© 2010 X.L. America, Inc. All Rights Reserved.
May not be copied without permission.
All other terms and conditions of the Policy remain unchanged.
misty.klemme Typewritten text 07/26/2022 misty.klemme
XIC 411 1013 © 2013 X.L. America, Inc. All Rights Reserved. Page 1 of 1 May not be copied without permission.
Includes copyrighted material of Insurance Services Office, Inc., with its permission.
SDOM 08/05/2020
POLICY NUMBER: XIC 411 1013
ENDORSEMENT #007
This endorsement, effective 12:01 a.m., July 26, forms a part of Policy No. issued to SWCA, INC. DBA: SWCA ENVIRONMENTAL CONSULTANTS by Greenwich Insurance Company.
AUTOMATIC ADDITIONAL INSURED
BUSINESS AUTO COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
AUTO DEALERS COVERAGE FORM
A. COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured, is amended to include as an “insured” any person or organization you are required in a written contract to name as an additional insured, but only for “bodily injury” or "property damage" otherwise covered under this policy caused, in whole or in part, by the negligent acts or omissions of:
1. You, while using a covered “auto”; or
2. Any other person, except the additional insured or any employee or agent of the additional insured, operating a covered “auto” with your permission;
Provided that:
a. The written contract is in effect during the policy period of this policy;
b. The written contract was signed by you and executed prior to the “accident” causing “bodily injury” or
“property damage” for which liability coverage is sought; and
c. Such person or organization is an “insured” solely to the extent required by the contract, but in no event if such person or organization is solely negligent.
B. The Limits of Insurance provided for the Additional Insured shall not be greater than those required by contract and, in no event shall the Limits of Insurance set forth in this policy be increased by the contract.
C. General Conditions, Other Insurance is amended as follows:
Any coverage provided hereunder shall be excess over any other valid and collectible insurance available to the additional insured whether such insurance is primary, excess, contingent or on any other basis unless the contract specifically requires that this policy be primary.
All terms, conditions, exclusions and limitations of this policy shall apply to the liability coverage provided to any additional insured, and in no event shall such coverage be enlarged or expanded by reason of the contract.
jenn.decker
AEC001910217
jenn.decker Typewritten text jenn.decker
AEC001910217
POLICY NUMBER: COMMERCIAL AUTO
CA 20 01 10 13
CA 20 01 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 2
LESSOR – ADDITIONAL INSURED AND LOSS PAYEE
AUTO DEALERS COVERAGE FORM
MOTOR CARRIER COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.
This endorsement changes the policy effective on the inception date of the policy unless another date is ind icated below.
Named Insured: SWCA, INC. DBA: SWCA ENVIRONMENTAL CONSULTANTS
Endorsement Effective Date:
Insurance Company: Greenwich Insurance Company
Policy Number: Effective Date:
Expiration Date:
Named Insured: SWCA, INC. DBA: SWCA ENVIRONMENTAL CONSULTANTS
Address: 20 E. THOMAS ROAD, SUITE 1700
PHOENIX, AZ 85012
Additional Insured (Lessor): See Endorsement # 005
Address:
Designation Or Description Of "Leased Autos": See Endorsement # 005
AEC001910217
jenn.decker Typewritten text
AEC001910217
jenn.decker Typewritten text 07/26/2022 jenn.decker Typewritten text 07/26/2023 jenn.decker
07/26/2022
CA 20 01 10 13 © Insurance Services Office, Inc., 2011 Page 2 of 2
Coverages Limit Of Insurance Covered Autos Liability $ Each "Accident"
Comprehensive Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ Deductible For Each Covered "Leased Auto"
Collision
Specified Causes Of Loss
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
A. Coverage
1. Any "leased auto" designated or described in the Schedule will be considered a covered "auto" you own and not a covered "auto" you hire or borrow.
2. For a "leased auto" designated or described in the Schedule, the Who Is An Insured provision under Covered Autos Liability Coverage is changed to include as an "insured" the lessor named in the Schedule. However, the lessor is an "insured" only for "bodily injury" or "property damage" resulting from the acts or omissions by:
a. You;
b. Any of your "employees" or agents; or
c. Any person, except the lessor or any
"employee" or agent of the lessor, operating a "leased auto" with the permission of any of the above.
3. The coverages provided under this endorsement apply to any "leased auto" described in the Schedule until the expiration date shown in the Schedule, or when the lessor or his or her agent takes possession of the "leased auto", whichever occurs first.
B. Loss Payable Clause
1. We will pay, as interest may appear, you and the lessor named in this endorsement for "loss" to a "leased auto".
2. The insurance covers the interest of the lessor unless the "loss" results from fraudulent acts or omissions on your part.
3. If we make any payment to the lessor, we will obtain his or her rights against any other party.
C. Cancellation
1. If we cancel the policy, we will mail notice to the lessor in accordance with the Cancellation Common Policy Condition.
2. If you cancel the policy, we will mail notice to the lessor.
3. Cancellation ends this agreement.
D. The lessor is not liable for payment of your premiums.
E. Additional Definition
As used in this endorsement:
"Leased auto" means an "auto" leased or rented to you, including any substitute, replacement or extra "auto" needed to meet seasonal or other needs, under a leasing or rental agreement that requires you to provide direct primary insurance for the lessor.
IXI 403 01 10
SDOM 08/05/2020
ENDORSEMENT #005
In consideration of the premium charged, it is hereby understood and agreed that:
On form CA 20 01 LESSOR – ADDITIONAL INSURED AND LOSS PAYEE
Additional Insured (Lessor) on the Schedule is amended to include:
ALL LESSORS
Designation or Description of “Leased Autos” on the Schedule is amended to include:
Any “Leased Auto”
All other terms and conditions remain the same.
(Authorized Representative) misty.klemme Typewritten text
AEC001910217
misty.klemme
COMMERCIAL AUTO
CA 04 49 11 16
CA 04 49 11 16 © Insurance Services Office, Inc., 2016 Page 1 of 1
PRIMARY AND NONCONTRIBUTORY –
OTHER INSURANCE CONDITION
AUTO DEALERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the
A. The following is added to the Other Insurance
Condition in the Business Auto Coverage Form and the Other Insurance – Primary And Excess Insurance Provisions in the Motor Carrier Coverage Form and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage is primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:
1. Such "insured" is a Named Insured under such other insurance; and
2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured".
B. The following is added to the Other Insurance Condition in the Auto Dealers Coverage Form and supersedes any provision to the contrary:
This Coverage Form's Covered Autos Liability Coverage and General Liability Coverages are primary to and will not seek contribution from any other insurance available to an "insured" under your policy provided that:
1. Such "insured" is a Named Insured under such other insurance; and
2. You have agreed in writing in a contract or agreement that this insurance would be primary and would not seek contribution from any other insurance available to such "insured".
misty.klemme
POLICY NUMBER: AEC001910217
POLICY NUMBER: COMMERCIAL AUTO
CA 04 44 10 13
CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1
WAIVER OF TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO US (WAIVER OF SUBROGATION)
This endorsement modifies insurance provided under the following:
AUTO DEALERS COVERAGE FORM
With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the
This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.
Named Insured: SWCA, INC. DBA: SWCA ENVIRONMENTAL CONSULTANTS
Endorsement Effective Date:
Name(s) Of Person(s) Or Organization(s):
WHERE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT EXECUTED
PRIOR TO LOSS (EXCEPT WHERE NOT PERMITTED BY LAW)
Information required to complete this Schedule, if not shown above, will be shown in the Declarations.
The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.
jenn.decker Typewritten text
AEC001910217
jenn.decker
07/26/2022
IXI 405 0910
SDOM 07/31/2020 © 2010 X.L. America, Inc. All Rights Reserved.
ENDORSEMENT #008
CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT
In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below:
Name of Person(s) or Entity(ies) Mailing Address:
Number of Days Advanced Notice of
Cancellation:
ANY PERSON(S) OR ENTITY(IES) REQUIRING
BY WRITTEN CONTRACT THAT THE NAMED
INSURED PROVIDE ADVANCED WRITTEN
NOTICE OF CANCELLATION. THE PERSON OR
ENTITY
REFER TO SPREADSHEET
PROVIDED BY BROKER
MUST BE LISTED ON A SPREADSHEET FROM
THE BROKER THAT INCLUDES THEENTITY'S
NAME
ENTITY'S NAME AND A VALID MAILING
ADDRESS. THIS SPREADSHEET MUST BE
RECEIVED
THE COMPANY WITHIN FIVE DAYS OF THE
COMPANY'S REQUEST TO THE BROKER.
OTHERWISE
THE COMPANY WILL BEAR NO
RESPONSIBILITY FOR SUCH ADVANCED
WRITTEN NOTICE OF
CANCELLATION
All other terms and conditions of the Policy remain unchanged.
Typewritten text jenn.decker
AEC001910217
This page has been left blank intentionally.
XCU 050 0811 © 2011 X.L. America, Inc. All Rights Reserved.
Includes copyrighted material of Insurance Services Offices, Inc., with its permission.
COMMERCIAL EXCESS FOLLOW FORM AND UMBRELLA LIABILITY POLICY
VARIOUS PROVISIONS IN THIS POLICY RESTRICT COVERAGE. READ THE ENTIRE POLICY CAREFULLY
TO DETERMINE YOUR RIGHTS, DUTIES AND WHAT IS AND WHAT IS NOT COVERED.
THIS POLICY IS INCOMPLETE UNLESS THE DECLARATIONS AND ALL APPLICABLE FORMS AND
ENDORSEMENTS ARE ATTACHED.
THROUGHOUT THIS POLICY THE WORDS “YOU” AND “YOUR” REFER TO THE NAMED INSURED SHOWN IN
DECLARATIONS ITEM 1 AND ANY OTHER PERSON OR ORGANIZATION QUALIFYING AS A NAMED
INSURED UNDER THIS POLICY. THE WORDS “WE”, “US”, AND “OUR” REFER TO THE COMPANY
PROVIDING THIS INSURANCE.
WORDS AND PHRASES THAT APPEAR IN BOLD HAVE SPECIAL MEANING AND ARE DEFINED IN SECTION
VI - DEFINITIONS.
I. INSURING AGREEMENTS
In consideration of the payment of premium, and subject to the terms, definitions, conditions and limitations of this policy, including any endorsements or amendments thereto, we agree with the named insured as follows:
(A) Insuring Agreement A - Excess Follow Form Liability
(1) We will pay on behalf of the insured, subject to Section IV. Limits of Insurance, those amounts the insured becomes legally obligated to pay as damages in excess of the scheduled underlying insurance as a result of a claim covered by the scheduled underlying insurance, but only if the scheduled underlying insurance has been exhausted by the actual payment of loss to which this policy applies.
(2) Coverage under this Insuring Agreement A shall follow the terms, definitions, conditions and limitations of the scheduled underlying insurance, subject to the policy period, Limits of Insurance, premium, and any contrary provisions contained in this policy.
However, this Insuring Agreement A will not apply to any disaster response expense as described in Insuring Agreement C, even if such insurance is covered by the scheduled underlying insurance or would have been but for the exhaustion of the scheduled underlying insurance.
(3) If we are prevented by law or statute from making payment on the insured’s behalf under Insuring Agreement A, we will indemnify the insured for those sums otherwise payable hereunder.
(B) Insuring Agreement B - Umbrella Liability Over Self-insured Retention
(1) We will pay on behalf of the insured, subject to Section IV. Limits of Insurance, those amounts not covered by the scheduled underlying insurance that the insured becomes legally obligated to pay as damages in excess of the self-insured retention because of bodily injury, property damage (including liability assumed by the insured under an insured contract) or personal and advertising injury taking place anywhere in the world and caused by an occurrence during the policy period.
(2) The coverage provided by Insuring Agreement B will not apply to damages that would have been covered by the scheduled underlying insurance but for its exhaustion by the payment of loss.
POLICY NUMBER: UEC001910317
Includes copyrighted material of Insurance Services Offices, Inc., with its permission.
(3) The coverage provided by Insuring Agreement B will not apply to any damages covered by Insuring Agreement A, or arising out of subjects of insurance or exposures to loss for which this policy requires the scheduled underlying insurance to be maintained.
(4) If we are prevented by law or statute from making payment on the insured’s behalf under Insuring Agreement B, we will indemnify the insured for those sums otherwise payable hereunder.
We will make payment on behalf of the insured under Insuring Agreements A and B only if:
(1) Prior to the policy period, no insured listed under Section II. Who Is An Insured, (B)(1), (6), (7), (8), (9) or (10); no manager in your risk management, insurance or legal department; and no employee authorized by you to give or receive notice of an occurrence, claim or suit; knew, prior to the policy period, that the bodily injury or property damage had occurred, in whole or in part, or of the existence of any occurrence that caused personal and advertising injury; or
(2) During the policy period, no insured listed under Section II. Who is An Insured, (B) (1),(6), (7), (8), (9) or (10); no manager in your risk management, insurance or legal department; and no employee authorized by you to give or receive notice of an occurrence, claim or suit; knew during the policy period, that the bodily injury or property damage had occurred, in whole or in part , or of the existence of any occurrence that caused personal and advertising injury, prior to the policy period.
For these purposes, bodily injury, property damage, and personal and advertising injury, including the continuation, change or resumption of such bodily injury, property damage, or personal and advertising injury, will be deemed to have been known at the earliest time when any of the above-referenced individuals:
(1) Reports all or any part of the bodily injury, property damage, or personal and advertising injury to us or any other insurer;
(2) Receives a claim because of the bodily injury, property damage, or personal and advertising injury; or
(3) Becomes aware by any other means that bodily injury or property damage has occurred or has begun to have occurred, or an occurrence has been committed that has caused or may cause personal and advertising injury.
(C) Insuring Agreement C - Disaster Response Coverage
(1) We will indemnify the insured for disaster response expenses resulting from a disaster event occurring during the policy period, provided:
(a) a disaster response advisor has been hired in connection with the disaster event; and
(b) a disaster event is reported to us at the number indicated in Declarations Item 8 within twenty-four (24) hours of its commencement.
(2) A disaster event will be deemed to commence when a key executive first becomes aware of a disaster event. A disaster event will be deemed to end when:
(a) we determine that any one of the elements listed in the definition of disaster event no longer exists; or
(b) the Disaster Response Expense Aggregate Limit listed in Declarations Item 3 has been exhausted, whichever is earlier.
Includes copyrighted material of Insurance Services Offices, Inc., with its permission.
(3) If we and the insured disagree on whether a disaster event has occurred, the insured’s right of reimbursement under Insuring Agreement C shall be arbitrated pursuant to the rules of the American Arbitration Association for the state shown in Declarations Item 1.
(4) Payment by us of disaster response expenses will not determine or be evidence of our rights or obligations under Insuring Agreement A or B.
(5) Payment by us of disaster response expenses will not oblige us to assume any duty to control the investigation, settlement or defense of any claim or suit that might arise from a covered disaster event.
II. WHO IS AN INSURED
(A) The following are insureds under Insuring Agreement A:
(1) The named insured.
(2) Any person or organization qualifying as an insured under the scheduled underlying insurance, but for no broader coverage than would be afforded to such person or organization by the scheduled underlying insurance.
(B) The following are insureds under Insuring Agreements B and C:
(1) The named insured.
(2) Any person or organization, other than an employee or volunteer worker, while such person or organization is acting as your real estate manager.
(3) Your legal representative if you die, but only with respect to his or her duties as such.
(4) Your employees, but only for acts within the scope of their employment by you, or while performing duties related to the conduct of your business.
(5) Your volunteer workers, but only while performing duties related to the conduct of your business.
(6) If you are designated in the Declarations as an individual, then your spouse, but only with respect to the conduct of a business of which you are the sole owner.
(7) If you are designated in the Declarations as a partnership or joint venture, your partners and their spouses, but only with respect to the conduct of your business.
(8) If you are designated in the Declarations as a limited liability company, your members, but only with respect to the conduct of your business, and your managers, but only with respect to their duties as such.
(9) If you are designated in the Declarations as an organization other than a partnership, joint venture or limited liability company, your executive officers and directors, but only with respect to their duties as such. Your stockholders are also insureds, but only with respect to their liability as stockholders.
(10) If you are designated in the Declarations as a trust, your trustees, but only with respect to their duties as such.
(11) Any organization in which you maintain an interest of more than fifty percent (50%) as of the effective date of this policy.
Includes copyrighted material of Insurance Services Offices, Inc., with its permission.
(12) A partnership, joint venture or limited liability company that you acquire or form during the policy period, but only if we have named such partnership, joint venture or limited liability company as an insured on a written endorsement that is made part of this policy.
III. DEFENSE AND SETTLEMENT
(A) We will have the right and duty to defend any suit covered by Insuring Agreement A, but only when the scheduled underlying insurance or other insurance has been exhausted by payment of loss to which this policy applies.
(B) We will have the right and the duty to defend any suit covered by Insuring Agreement B, but only when such suit seeks damages because of bodily injury, property damage, or personal and advertising injury that are not covered by the scheduled underlying insurance or by other insurance.
(C) When we assume the defense of any suit under Paragraph (A) or (B) above, we will have the right to investigate, defend and settle such suit as we deem appropriate. We will defend any such suit even if it is groundless, false or fraudulent. We also will pay the following supplementary payments in connection with any suit we defend, but only if such supplementary payments are not covered by the scheduled underlying insurance or any other insurance:
(1) Premiums on appeal bonds or bonds to release attachments, subject to the applicable Limits of Insurance set forth in the Declarations, provided that we will not be obligated to apply for or furnish any such bond.
(2) All costs taxed against an insured in connection with the suit.
(3) Pre-judgment interest awarded against the insured on that part of any judgment paid under this policy, but only such interest as shall accrue before we make a settlement offer within the policy’s applicable Limits of Insurance.
(4) Post-judgment interest that accrues after entry of judgment and before we have paid, offered to pay, or deposited in court, that part of the judgment that is within this policy’s applicable Limits of Insurance.
(5) Reasonable expenses incurred by an insured at our request or with our consent.
(D) We will have no duty to defend, investigate, pay or settle, or continue to defend, investigate, pay or settle, a suit after the applicable Limits of Insurance set forth in the Declarations have been exhausted by the payment of loss; in which case we will have the right to withdraw and discontinue our investigation or defense of such suit.
(E) We will have no duty to defend the insured against any suit seeking damages to which this insurance does not apply.
(F) If we are prevented by law or statute from assuming our defense obligations under Paragraph (A) or (B), we will pay any expenses incurred by you with our consent in connection with the defense of a suit otherwise covered by that section.
(G) Except as otherwise provided in this Section III. Defense and Settlement, we shall have no duty to defend any suit against an insured. We, however, will have the right, but not the duty, to associate with you in the investigation, settlement or defense of any claim or suit to which this policy applies, in which case the insured will cooperate with us and make available all information and records we reasonably require. We will exercise our right to associate at our expense.
IXI 405 0910
RISH 08/04/2020 © 2010 X.L. America, Inc. All Rights Reserved.
ENDORSEMENT #012
SWCA, INC. DBA: SWCA ENVIRONMENTAL CONSULTANTS by XL Specialty Insurance Company.
CANCELLATION NOTIFICATION TO OTHERS ENDORSEMENT
In the event coverage is cancelled for any statutorily permitted reason, other than nonpayment of premium, advanced written notice will be mailed or delivered to person(s) or entity(ies) according to the notification schedule shown below:
Name of Person(s) or Entity(ies) Mailing Address:
Number of Days Advanced Notice of
Cancellation:
ANY PERSON(S) OR ENTITY(IES) REQUIRING BY
WRITTEN CONTRACT THAT THE NAMED INSURED
PROVIDE ADVANCED WRITTEN NOTICE OF
CANCELLATION. THE PERSON OR ENTITY MUST BE
LISTED ON A SPREADSHEET FROM THE BROKER THAT
INCLUDES THE PERSON'S OR ENTITY'S NAME AND VALID
MAILING ADDRESS. THIS SPREADSHEET MUST BE
RECEIVED BY THE COMPANY WITHIN FIVE DAYS OF THE
COMPANY'S REQUEST TO THE BROKER. OTHERWISE,
THE COMPANY WILL BEAR NO RESPONSIBILITY FOR
SUCH ADVANCED WRITTEN NOTICE OF CANCELLATION
REFER TO
SPREADSHEET
PROVIDED BY BROKER
All other terms and conditions of the Policy remain unchanged.
Typewritten text jenn.decker
UEC001910317
1983 National Council on Compensation Insurance.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 4-84)
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
Schedule
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured Premium
Insurance Company Countersigned by ___________________________________________
WC 00 03 13
(Ed. 4-84)
Where required by written agreement signed prior to loss.
Included SWCA, Inc. DBA: SWCA ENVIRONMENTAL CONSULTANTS
07/26/2022 WEC001910617
XL Specialty Insurance Company
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06
(Ed. 04-84)
WC 04 03 06 Page 1 of 1 (Ed. 04-84) Copyright 1984 Workers' Compensation Insurance Rating Bureau of California. All Rights Reserved.
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENTCALIFORNIA
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule.
The additional premium for this endorsement shall be 2 % of the California workers’ compensation premium otherwise due on such remuneration.
Schedule
Person or Organization Job Description
Where required by written agreement signed prior to loss All California Operations.
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective Policy No. Endorsement No.
Insured SWCA, Inc. DBA: SWCA ENVIRONMENTAL
CONSULTANTS
Insurance Company Greenwich Insurance Company
Countersigned By
© Copyright 2014 National Council on Compensation Insurance, Inc. All Rights Reserved.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 42 03 04 B
(Ed. 6-14)
TEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Texas is shown in Item 3.A. of the Information Page.
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule, but this waiver applies only with respect to bodily injury arising out of the operations described in the Schedule where you are required by a written contract to obtain this waiver from us.
This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
The premium for this endorsement is shown in the Schedule.
1. ( ) Specific Waiver Name of person or organization ( ) Blanket Waiver Any person or organization for whom the Named Insured has agreed by written contract to furnish this waiver.
2. Operations:
3. Premium:
The premium charge for this endorsement shall be percent of the premium developed on payroll in connection with work performed for the above person(s) or organization(s) arising out of the operations described.
4. Advance Premium:
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Insured Premium
Insurance Company Countersigned by __________________________________________
WC 42 03 04 B
(Ed. 6-14)
X
All Texas Operations
SWCA, Inc. DBA: SWCA ENVIRONMENTAL CONSULTANTS Included
2.000
2000 National Council on Compensation Insurance, Inc.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 43 03 05
(Ed. 7-00)
UTAH WAIVER OF SUBROGATION ENDORSEMENT
This endorsement applies only to the insurance provided by the policy because Utah is shown in Item 3.A. of the Information Page.
We have the right to recover our payments from anyone liable for an…
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