25-26_ICHD-WOS-CP-1025814-3.pdf

This document is a Workers Compensation and Employers Liability Insurance Policy Endorsement issued by CopperPoint Casualty Insurance Company, specifically the Alaska National division. The policy is for Intermountain Centers for Human Development, with an endorsement effective date of 01/01/2025 and a policy number of WC1025814. The endorsement includes a "Waiver of Our Right to Recover from Others" clause, which modifies the standard insurance policy terms.

The endorsement carries a premium of $3,777.00 and provides a waiver that allows the insurance company to not enforce recovery rights against parties named in a schedule who are liable for a work-related injury, specifically when the insured performs work under a written contract requiring this agreement. The document is dated and copyrighted by the National Council on Compensation Insurance, Inc., with an edition date of 04-1984, and is countersigned by an authorized representative of CopperPoint Casualty Insurance Company.