CTR062830_-_WC_Endorsement.pdf
PDF 66 KB Posted
- Attached to
- Master Agreement AZ|CTR062830
- Contract number
- CTR062830
- Issued by
- Arizona
About this file
This document is a Workers Compensation and Employers Liability Insurance Policy Waiver of Right to Recover from Others Endorsement for Arizona Youth Partnership, Inc., issued by Wesco Insurance Company. The policy is effective from 12/1/2023, with a policy number of WWC3685299 and an endorsement number of 0. The premium for this policy is $8,670.
The endorsement specifically provides a waiver of the insurance company's right to recover payments from any person or organization as required by a written contract. The document does not detail specific goods or services, but instead focuses on the insurance coverage and the conditions under which the insurer will not enforce its right to recover payments for injuries covered by the policy. The schedule broadly defines the scope as "Any person or organization as required by written contract," indicating flexibility in application across different contractual arrangements.
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Text version
WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT
We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.)
This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13
(Ed. 04-84)
Schedule Any person or organization as required by written contract
This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated.
(The information below is required only when this endorsement is issued subsequent to preparation of the policy.)
Endorsement Effective 12/1/2023 Policy No. WWC3685299 Endorsement No. 0 Insured Arizona Youth Parnership, Inc. Premium $ 8,670 Insurance Company Wesco Insurance Company
Countersigned by
WC 00 03 13
(Ed. 04-84)
File details come from the government source that posted it. Updated .