CTR056118-WCWOS.pdf
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- Attached to
- Master Agreement AZ|CTR056118
- Contract number
- CTR056118
- Issued by
- Arizona
About this file
This document is a Workers Compensation policy endorsement with the policy number R2WC467997, issued by an insurance services office and dated June 1997. The endorsement specifically involves the State of Arizona, including its departments, agencies, boards, commissions, universities, and associated officers, officials, agents, and employees. The document is a Waiver of Transfer of Rights of Recovery Against Others To Us, which modifies the existing workers compensation insurance policy.
The endorsement provides a specific waiver of recovery rights for losses arising from work performed by or on behalf of a contractor. Specifically, the insurance provider waives any right of recovery against the State of Arizona for injury or damage arising from the contractor's ongoing operations or work completed under a contract. This waiver applies to work included in the "products-completed operations hazard" and is limited to the State of Arizona and its associated entities as outlined in the schedule. The endorsement ensures that the insurance company cannot seek reimbursement from the state for claims related to the specified contractual work.
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Text version
91-3306 1st Edition 6-97 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1
POLICY NUMBER: R2WC467997 Workers Compensation
E3306
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Waiver of Transfer of Rights of Recovery
Against Others To Us This endorsement modifies insurance provided under the following:
WORKERS COMPENSATION
SCHEDULE*
Name Of Person Or Organization:
The State of Arizona, its departments, agencies, boards, commissions, universities and its officers, officials, agents and employees for losses arising from work performed by or on behalf of the
Contractor.
* Information required to complete this Schedule, if not shown on this endorsement, will be shown in the Declarations.
The provisions of the Businessowners Common Policy Conditions are modified by this endorsement as follows:
Condition K. Transfer of Rights Of Recovery Against Others To Us in the Businessowners Common Policy Conditions is amended by the addition of the following:
3. We waive any right of recovery we may have against the person or organization shown in the Schedule above because of payments we make for injury or damage arising out of your ongoing operations or “your work” done under a contract with that person or organization and included in the “products-completed operations hazard.” This waiver applies only to the person or organization show in the Schedule above.
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