CTR052593_-_WC_WOS.pdf

This document is a Workers Compensation and Employers Liability Insurance Policy Waiver of Right to Recover from Others Endorsement issued by CopperPoint Indemnity Insurance Company. The policy is associated with St. Mary's Food Bank Alliance and is effective from 07/01/2024, with Policy No. 1001987. The scheduled party is the State of Arizona, which includes its departments, agencies, boards, commissions, universities, and its officers, officials, agents, and employees.

The endorsement specifically outlines the insurance company's agreement to waive its right to recover payments from the State of Arizona for work-related injuries covered under the policy. The premium for this endorsement is $100.00, and it changes the underlying insurance policy to which it is attached. The waiver applies only to situations where work is performed under a written contract that requires obtaining this specific agreement, and it is designed to prevent the insurance company from seeking recovery from the State of Arizona for losses arising from work performed by or on behalf of the contractor.