ACCEPTED SIR.pdf

This document is a Self-Insured Retention (SIR) Practices form from the Arizona Department of Transportation (ADOT) Risk Management, accepted on 8/11/23, pertaining to Midway Chevrolet Company 1, LLC, which operates in Arizona. The document outlines the company's self-insurance mechanisms and practices, establishing the company as authorized to self-insure under applicable regulations.

The company self-insures various liability risks on a per occurrence basis, including: general liability up to $2 thousand per occurrence, automobile liability up to $2 thousand per occurrence, workers' compensation and employers' liability up to $1 thousand per occurrence, and occupational accident risks up to $5 thousand per occurrence. The document stipulates that the company maintains adequate financial resources to meet these self-insurance obligations, agrees to provide financial records upon request, and confirms that its self-insurance will be primary with respect to ADOT. The company also waives its rights of recovery in subrogation for claims related to ADOT or the State of Arizona.