24-ICHD_24-25_WORK_-_State_specified_WOS.pdf

This document is a Workers Compensation and Employers Liability Insurance Policy endorsement from CopperPoint National Insurance Company, specifically a Waiver of Right to Recover from Others Endorsement. The policy is issued for the State of Arizona (AZ), covering the state, its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.

The endorsement is effective 01/01/2024 with Policy No. 1025814, issued to Intermountain Centers for Human Development. The document provides a blanket waiver allowing the insurance company to waive its right to recover payments from parties liable for work-related injuries, but only to the extent of written contractual requirements. The endorsement is marked as Premium $, with Endorsement No. 9, and is countersigned by a representative of the insurance company.