CTR052593_-_AI.pdf
PDF 40 KB Posted
- Attached to
- Master Agreement AZ|CTR052593
- Contract number
- CTR052593
- Issued by
- Arizona
About this file
This document is an insurance policy endorsement for additional insured status, specifically for the State of Arizona. The endorsement modifies several coverage parts including Commercial General Liability, Human Services Organization Professional Liability, Sexual or Physical Abuse Liability, and Business Auto Coverage. The policy is numbered PHPK2620722 and covers the period from 10/31/2023 to 10/31/2024, with the State of Arizona and its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees listed as the additional insured.
The endorsement provides primary coverage for activities performed by or on behalf of the contractor, including assumption of liability through written or oral contracts. Key provisions include expanding the definition of who is an insured to include the State of Arizona, ensuring coverage is primary with other insurance applying as excess, and waiving subrogation rights against the state and its entities for losses arising from the contractor's work. The endorsement does not specify specific goods or services, but rather provides a broad insurance coverage mechanism for the state's contracted work.
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Text version
MANUSCRIPT (06/11)
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED – STATE OF ARIZONA
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
HUMAN SERVICES ORGANIZATION PROFESSIONAL LIABILITY COVERAGE FORM
SEXUAL OR PHYSICAL ABUSE OR MOLESTATION VICARIOUS LIABILITY COVERAGE FORM
BUSINESS AUTO COVERAGE FORM
Policy No.
Policy Term.
SCHEDULE
Name of Person or Organization: State of Arizona
The State of Arizona, its departments, agencies, boards commissions, universities and its officers, officials, agents, and employees for losses arising out of the work performed by or on behalf of the Contractor
The following provisions are added to the policy:
1. WHO IS AN INSURED is amended to include as an insured the person or organization shown in the above
SCHEDULE, but only with respect to their liability for activities performed by you or on your behalf relating to the conduct of your business;
2. The coverage provided by this endorsement includes the assumption of liability in a written or oral contract between the named insured and the person or organization shown in the above SCHEDULE for work performed by you or on your behalf relating to the conduct of your business;
3. The coverage provided by this endorsement only is primary. Any other applicable insurance will apply as excess; and
4. We agree to waive any right of subrogation against 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 Subcontractor
Revised 6/13/12 Page 1 of 1 landerso Typewritten Text
PHPK2620722
landerso Typewritten Text 10/31/2023-10/31/2024
File details come from the government source that posted it. Updated .