CTR052593_-_AO_Endorsements__1_.pdf

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Attached to
Master Agreement AZ|CTR052593
Contract number
CTR052593
Issued by
Arizona

About this file

These documents are Commercial Auto Insurance Policy endorsements for St. Mary's Food Bank Alliance, with the State of Arizona designated as an additional insured party. The policy documents include a Waiver of Transfer of Rights of Recovery (Waiver of Subrogation) and a Designated Insured for Covered Autos Liability Coverage endorsement, both effective 10/31/2024 and sharing the policy number PHPK2620722-012.

The endorsements modify the insurance coverage to provide specific protections for the State of Arizona, including waiving subrogation rights and extending liability coverage. The State of Arizona, along with its departments, agencies, boards, commissions, universities, officers, officials, agents, and employees, are named as additional insureds with respect to liability arising from activities performed by or on behalf of the contractor. The policy ensures comprehensive auto liability coverage that protects both St. Mary's Food Bank Alliance and the State of Arizona under the specified terms.

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Text version

POLICY NUMBER: COMMERCIAL AUTO

CA 04 44 10 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page of

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US (WAIVER OF SUBROGATION)

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement.

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Named Insured:

Endorsement Effective Date:

SCHEDULE

Name(s) Of Person(s) Or Organization(s):

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the "loss" under a contract with that person or organization.

PHPK2620722-012

10/31/2024

St. Mary's Food Bank Alliance

State of Arizona (Complete Name per manuscript)

1 1

POLICY NUMBER: COMMERCIAL AUTO

CA 20 48 10 13

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CA 20 48 10 13 © Insurance Services Office, Inc., 2011 Page of

DESIGNATED INSURED FOR

COVERED AUTOS LIABILITY COVERAGE

This endorsement modifies insurance provided under the following:

AUTO DEALERS COVERAGE FORM

BUSINESS AUTO COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement.

This endorsement identifies person(s) or organization(s) who are "insureds" for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form.

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Named Insured:

Endorsement Effective Date:

SCHEDULE

Name Of Person(s) Or Organization(s):

Information required to complete this Schedule, if not shown above, will be shown in the Declarations.

Each person or organization shown in the Schedule is an "insured" for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II – Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I – Covered Autos Coverages of the Auto Dealers Coverage Form.

PHPK2620722-012

10/31/2024

St. Mary's Food Bank Alliance

The State of Arizona (See Manuscript)

2 2

PI-MANU-1 (01/00)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY

All other terms and conditions of this Policy remain unchanged.

The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents, employees, shall be named as additional insured with respect to liability arising out of the activities performed by or on behalf of Contractor.

Additional Insured - State of Arizona

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