AARP_Foundation_-_Endorsement.pdf

FAIC-SKLBUS-COCHG (6/01)

Policy Number

THIS ENDORSEMENT CHANGES THE POLICY.

PLEASE READ IT CAREFULLY.

COMMON POLICY CHANGE ENDORSEMENT

Endorsement No.

Named Insured Effective Date:

12:01 A.M., Standard Time

Agent Name Agent No.

This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or conditions of coverage unless at the sole request of the insured.

COVERAGE PART INFORMATION ---- Coverage parts affected by this change as indicated by x below.

Commercial Property

Commercial General Liability

Commercial Crime

Commercial Inland Marine

The following item(s):

Insured’s Name Insured’s Mailing Address

Policy Number Company

Effective/Expiration Date Insured’s Legal Status/Business of Insured

Payment Plan Premium Determination

Additional Interested Parties Coverage Forms and Endorsements

Limits/Exposures Deductibles

Covered Property/Location Description Classification /Class Codes

Rates Underlying Exposure/ Insurance is (are) changed to read {See Additional Page(s) }

The above amendments result in a change in the premium as follows:

This premium does not include taxes and surcharges.

No Changes To be Adjusted at Audit Additional Return

Tax and Surcharge Changes

Additional Return

Countersigned By:

AUTHORIZED AGENT

11GPP4936916

08-10-23

14055 LOCKTON COMPANIES, LLC (NORTHEAST SERIES)

AARP

ARCH INSURANCE COMPANY

X NO CHARGE

X NO CHARGE NO CHARGE

THE FOLLOWING FORM(S) HAS BEEN AMENDED:

CG 24 04 12-19 WAIVER OF TRANSFER RIGHTS OF RECOVERY

ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME

CG 24 04 12 19 © Insurance Services Office, Inc., 2018 Page 1 of 1

POLICY NUMBER: 11GPP4936916 COMMERCIAL GENERAL LIABILITY

CG 24 04 12 19

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

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):

THE STATE OF ARIZONA, AND ITS DEPARTMENTS, AGENCIES, BOARDS,

COMMISSIONS, UNIVERSITIES, OFFICERS, OFFICIALS, AGENTS, AND EMPLOYEES

FOR LOSSES ARISING FROM WORK PERFORMED BY OR ON BEHALF OF THE

CONTRACTOR.

P.O. BOX 6123

PHOENIX, AZ 85005

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.

This endorsement modifies insurance provided under the following: